Provider Demographics
NPI:1063561983
Name:SHAW-HIOKI, JEAN EVELYN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:EVELYN
Last Name:SHAW-HIOKI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 BROADWAY BLVD NE STE 103
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-2300
Mailing Address - Country:US
Mailing Address - Phone:505-766-9361
Mailing Address - Fax:505-766-9157
Practice Address - Street 1:707 BROADWAY BLVD NE STE 103
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-2300
Practice Address - Country:US
Practice Address - Phone:505-766-9361
Practice Address - Fax:505-766-9157
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-05422104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker