Individual
JUDITH LEE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
HWY 571 BLDG #28, EL RITO, NM 87530
(575) 581-4728
(575) 581-0030
Mailing address
686 CALLECITA JICARILLA, SANTA FE, NM 87505-4940
(575) 581-4728
(575) 581-0030
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-06403
NM
Other
Enumeration date
10/22/2008
Last updated
10/22/2008
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