Individual
MARILYN SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW-T
Contact information
Practice address
3450 N ROCK RD STE 405, WICHITA, KS 67226-1354
(316) 779-8185
Mailing address
3450 N ROCK RD STE 405, WICHITA, KS 67226-1354
(316) 779-8185
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12966-T
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12966-T
BCBS
KS
05
—
12966-T
—
KS
Enumeration date
01/24/2023
Last updated
01/24/2023
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