MEDICARE: LAURA AUBREE SHAY 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
1	104100000X	Social Worker	40893	TX

General Provider Information

NPI Number	:	1386732733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA AUBREE SHAY LMSW

Provider Business Mailing Address
First Line	:	7600 BROADWAY
Second Line	:	#A2
City	:	SAN ANTONIO
State	:	TX
Zip	:	78209
Country	:	US
Telephone Number	:	210-842-3174
Fax Number	:

Provider Business Practice Location Address
First Line	:	2135 BABCOCK RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229
Country	:	US
Telephone Number	:	210-614-7070
Fax Number	:	210-615-0249

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	07/08/2007

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