Individual
MRS. TACI SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA.LDT
Contact information
Practice address
2145 PRIEST BRIDGE DR, SUITE #4, CROFTON, MD 21114-2477
(443) 449-8689
Mailing address
2426 VINEYARD LN, CROFTON, MD 21114-1114
(443) 448-8689
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/30/2016
Last updated
03/30/2016
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