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Individual

MELINDA SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
425 LAURICELLA CT, ENGLEWOOD, OH 45322
(937) 836-5143
(937) 836-3934
Mailing address
642 COPPERFIELD LN, TIPP CITY, OH 45371-8804

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
02393
OH

Other

Enumeration date
09/15/2008
Last updated
09/15/2008
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