Individual
REBECCA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
237 OLD FARM DR, GREAT MEADOWS, NJ 07838-6002
(551) 574-1702
Mailing address
237 OLD FARM DR, GREAT MEADOWS, NJ 07838-6002
(551) 574-1702
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/11/2020
Last updated
11/13/2020
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