Individual
MADDIE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 DIXON AVE, AMITYVILLE, NY 11701-2994
(845) 514-8720
Mailing address
234 RIVER AVE APT 37, PATCHOGUE, NY 11772-3349
(907) 747-3636
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
131979
NY
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/30/2023
Last updated
07/16/2026
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