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1063272292
INGRID L SHADOW
FORT WORTH, TX
NPI
1063272292
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: TX 35298)
Enumeration Date
2024-03-22
Last Update Date
2024-03-22
Business Address
INGRID L SHADOW LCSW
3540 MANDERLY PL
FORT WORTH, TX 76109-4520
Phone number: 817-739-8170
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Mailing Address
INGRID L SHADOW LCSW
3540 MANDERLY PL
FORT WORTH, TX 76109-4520
Phone number: 817-739-8170
Copy
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