Individual
ALEXANDRA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3851 COMMERCIAL CENTER DR, LADSON, SC 29456-4146
(843) 314-5434
Mailing address
3851 COMMERCIAL CENTER DR, LADSON, SC 29456-4146
(843) 314-5434
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6304
SC
235Z00000X
Speech-Language Pathologist
SZ6855
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013320400
—
FL
05
—
SA1822
—
SC
Enumeration date
09/11/2014
Last updated
02/22/2021
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