| Doctor Name: | ROSE SHAW |
| NPI Number: | 1720458631 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | UNDER SUPERVISION |
| Business Practice Address: | 1301 Sunset Rd Pawhuska, OK - 740562483 |
| Business Phone Number: | 9182873236 |
| Business Fax Number: | |
| Mailing Address: | 1301 Sunset Rd, PAWHUSKA |
| State: | OK |
| Postal Code: | 740562483 |
| Phone Number: | 9182873236 |
| Fax Number: | |
| NPI Enumeration Date: | 10/05/2015 |
| NPI Last Update Date: | 10/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | UNDER SUPERVISION |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |