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Individual

MOLLY SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
21505 43RD AVE APT 9, BAYSIDE, NY 11361-2913
(401) 499-2153
Mailing address
21505 43RD AVE APT 9, BAYSIDE, NY 11361-2913

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary

Other

Enumeration date
04/27/2009
Last updated
04/27/2009
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