Provider Demographics
NPI:1346670916
Name:SHAW, BARROVETTE (MA)
Entity Type:Individual
Prefix:
First Name:BARROVETTE
Middle Name:
Last Name:SHAW
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 40TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-7309
Mailing Address - Country:US
Mailing Address - Phone:470-258-8871
Mailing Address - Fax:
Practice Address - Street 1:2101 40TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-3335
Practice Address - Country:US
Practice Address - Phone:470-258-8871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-19
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health