Most Relevant Information
Provider Data
| NPI Number: | 1003239963 |
| Provider Name: | ELIZABETH MAGANA SHAW LMSW |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 6801087916 |
Most Important Dates
| Enumeration Date: | 01/29/2014 |
| Last Updated: | 10/07/2022 |
Provider Practice Location
13101 ALLEN RD STE 500
SOUTHGATE
MI
481952216
Practice Location Phone/Fax
| Phone: | 7347857700 |
| Fax: | 7342871953 |
Provider Mailing Location
1370 RIVERBANK ST
LINCOLN PARK
MI
481463834
Provider Mailing Phone/Fax
| Phone: | 3132684454 |
| Fax: |