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General NPI Number Information
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NPI Number | 1689992778
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Entity Type | Individual
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Provider Name | NANCY SHAW PHD
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Gender | Female
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Dates
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Enumeration Date | 05/13/2010
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Last Update Date | 05/13/2010
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Provider Practice Location Address
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Address Line | 6346 GENE TERRY RD
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City | COTTONWOOD
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State | AL
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Zip | 36320-4253
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Country | US
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Telephone | 334-699-8743
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Fax | 334-699-8748
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Provider Business Mailing Address
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Address Line | 6346 GENE TERRY ROAD
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City | COTTONWOOD
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State | AL
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Zip | 36320
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Country | US
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Telephone | 334-699-8743
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Fax | 334-699-8748
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 846
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License Number State | AL
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