Individual
DENNISHA MICHELLE SHAW-GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1331 12TH AVE, ALTOONA, PA 16601-3340
(814) 201-2754
Mailing address
1331 12TH AVE STE 300, ALTOONA, PA 16601-3340
(814) 201-2754
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW139338
PA
Other
Enumeration date
06/28/2022
Last updated
06/28/2022
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