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Individual

MRS. ANGELA GREENWALD SHAW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
922 MYRTLE AVE, DIXON, IL 61021-1430
(815) 973-4928
Mailing address
922 MYRTLE AVE, DIXON, IL 61021-1430
(815) 973-4928

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146005644
IL

Other

Enumeration date
10/25/2017
Last updated
10/25/2017
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