Individual
DR. AMANDA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
247 PARK AVE, ROCHESTER, NY 14607-2723
(505) 402-3639
(585) 244-0629
Mailing address
247 PARK AVE, ROCHESTER, NY 14607-2723
(505) 402-3639
(585) 244-0629
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
022686-1
NY
Other
Enumeration date
06/13/2018
Last updated
06/13/2018
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