Individual
AMANDA J SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN
Contact information
Practice address
52 SHARON ST, MALDEN, MA 02148-5915
(339) 223-5850
Mailing address
52 SHARON ST, MALDEN, MA 02148-5915
(339) 223-5850
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/13/2011
Last updated
12/13/2011
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