Provider Demographics
NPI:1821676842
Name:SHAW, CASSANDRA (PHD, NBC-HWC)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:
Last Name:SHAW
Suffix:
Gender:F
Credentials:PHD, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 WAXWING WAY
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-0025
Mailing Address - Country:US
Mailing Address - Phone:864-580-9278
Mailing Address - Fax:
Practice Address - Street 1:34 WAXWING WAY
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-0025
Practice Address - Country:US
Practice Address - Phone:864-580-9278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date: