Individual
MRS. MIIKA RENAE MARIE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
131 HATCHER LN STE A, CLARKSVILLE, TN 37043-5921
(931) 444-1449
Mailing address
7500 SAN FELIPE ST STE 990, HOUSTON, TX 77063-1708
(866) 610-0580
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/19/2025
Last updated
05/19/2025
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