Individual
ELSIE ROSE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
64 PARK ST, DEXTER, ME 04930-1470
(207) 924-5516
Mailing address
48 MAIN ST, DETROIT, ME 04929-3236
(207) 416-3627
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OA3893
ME
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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