Individual
BAILEY MARIE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6670 SAINT VINCENT AVE, SHREVEPORT, LA 71106-2638
(318) 626-0500
Mailing address
6670 SAINT VINCENT AVE, SHREVEPORT, LA 71106-2638
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/17/2023
Last updated
04/17/2023
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