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NPI Code Detail

MEDICARE: MARIAM AISHA SHAFI LMSW

MEDICARE: MARIAM AISHA SHAFI LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1184141921
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIAM AISHA SHAFI LMSW
Provider Business Mailing Address
First Line : 11 WOODLAND DR
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-6086
Country : US
Telephone Number : 817-233-1432
Fax Number :
Provider Business Practice Location Address
First Line : 1527 HEMPHILL ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-4706
Country : US
Telephone Number : 817-569-5900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2017
Last Update Date : 08/23/2017

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Directions to “ MARIAM AISHA SHAFI LMSW” Practice Location

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