Provider Demographics
NPI:1477870475
Name:SHAW, ARNETRA DION (MA)
Entity type:Individual
Prefix:MISS
First Name:ARNETRA
Middle Name:DION
Last Name:SHAW
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4540 ROCKINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28351-9484
Mailing Address - Country:US
Mailing Address - Phone:910-582-4316
Mailing Address - Fax:910-585-8267
Practice Address - Street 1:4540 ROCKINGHAM RD
Practice Address - Street 2:
Practice Address - City:LAUREL HILL
Practice Address - State:NC
Practice Address - Zip Code:28351-9484
Practice Address - Country:US
Practice Address - Phone:910-582-4316
Practice Address - Fax:910-585-8267
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC259523101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health