Individual
MS. KEELEY SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1600 CRIDER RD, MANSFIELD, OH 44903
(440) 228-6587
Mailing address
1845 WESTOVER CT, MANSFIELD, OH 44906
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
05492
OH
Other
Enumeration date
06/16/2015
Last updated
06/16/2015
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