Individual
MARY SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNC
Contact information
Practice address
2558 DARROCH CT, NAPA, CA 94558-2616
(707) 258-0852
Mailing address
2558 DARROCH CT, NAPA, CA 94558-2616
(707) 258-0852
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
NON REQUIRED
CA
Other
Enumeration date
02/02/2011
Last updated
02/02/2011
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