Provider Information for 1326878307
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Mrs. TIFFANY R SHAW LCSW
Sex: Female
NPI: 1326878307
Last Updated: 2024-08-05
Certification Date: 2024-08-05
Certification Date: 2024-08-05
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1326878307 | ||||||||
| Enumeration Date | 2024-08-05 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 84 BREAUX BRIDGE, LA 70517-0084 United States Phone: 337-351-7071 | Fax: | ||||||||
| Primary Practice Address | 3310 DAISY MEADOWS LN BREAUX BRIDGE, LA 70517-6978 United States Phone: 337-351-7071 | Fax: | ||||||||
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