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1619993136
CORELLA H SHAW
CONWAY, SC
NPI
1619993136
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Enumeration Date
2006-07-15
Last Update Date
2007-07-08
Business Address
-- CORELLA H SHAW
164 WACCAMAW MEDICAL PARK DR
CONWAY, SC 29526-8903
Phone number: 843-347-5060
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Mailing Address
-- CORELLA H SHAW
68 IVORY DR
KINGSTREE, SC 29556-7048
Phone number: 843-382-5971
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