Individual
MARY BROOKE SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
114 W UNION ST, MUNFORDVILLE, KY 42765-8911
(270) 551-2114
Mailing address
810 LEGION PARK RD, GREENSBURG, KY 42743-1013
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
246533
KY
Other
Enumeration date
05/15/2023
Last updated
05/15/2023
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