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Individual

CIERRA SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1816 BRIARWOOD INDUSTRIAL CT NE STE A, BROOKHAVEN, GA 30329-1642
(404) 636-5272
Mailing address
866 EDGEWATER CIR, MARIETTA, GA 30062-3896
(470) 514-6623

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007829
GA

Other

Enumeration date
01/21/2021
Last updated
01/21/2021
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