Individual
ANDREA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18 WESTERN AVE, GLOUCESTER, MA 01930-3665
(802) 779-4606
Mailing address
18 WESTERN AVE, GLOUCESTER, MA 01930-3665
(802) 779-4606
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
11505
MA
Other
Enumeration date
04/07/2015
Last updated
08/23/2016
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