Individual
COLLEEN SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10111 N CANTERBURY RD, PHILADELPHIA, PA 19114-1113
(267) 230-8312
Mailing address
10111 N CANTERBURY RD, PHILADELPHIA, PA 19114-1113
(267) 230-8312
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
02/24/2015
Last updated
02/24/2015
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