Individual
AMANDA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMHC
Contact information
Practice address
5131 MANATEE AVE W, BRADENTON, FL 34209-3740
(941) 792-0802
Mailing address
5613 FISHERMANS DR, BRADENTON, FL 34209-6770
(321) 557-6389
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH20223
FL
Other
Enumeration date
01/24/2022
Last updated
01/24/2022
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