Individual
AMANDA D SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23800 NORTHWESTERN HWY STE 190L, SOUTHFIELD, MI 48075-7740
(231) 412-9278
Mailing address
23800 NORTHWESTERN HWY STE 190L, SOUTHFIELD, MI 48075-7740
(231) 412-9278
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/02/2025
Last updated
09/02/2025
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