Individual
COLLEEN MARIE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 N HANCOCK ST, PHILADELPHIA, PA 19123-2334
(267) 978-4305
Mailing address
320 W POTHOUSE RD, PHOENIXVILLE, PA 19460-2363
(484) 354-9488
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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