Individual
AMBER SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5323 E 12TH ST APT 30, TULSA, OK 74112-5308
(918) 886-7164
Mailing address
5323 E 12TH ST APT 30, TULSA, OK 74112-5308
(918) 886-7164
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/10/2025
Last updated
11/10/2025
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