Individual
AMANDA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 GROVE ST STE 307, WORCESTER, MA 01605-2654
(978) 206-1682
Mailing address
100 GROVE ST STE 307, WORCESTER, MA 01605-2654
(978) 206-1682
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
22121
MA
1041C0700X
Clinical Social Worker
Primary
121609
MA
Other
Enumeration date
07/21/2016
Last updated
07/31/2023
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