Individual
JESSICA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
920 S 4TH ST, LOUISVILLE, KY 40203-3206
(502) 560-5164
Mailing address
920 S 4TH ST, LOUISVILLE, KY 40203-3206
Taxonomy
Speciality
Code
Description
License number
State
225XG0600X
Gerontology Occupational Therapist
Primary
—
—
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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