Individual
AMANDA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1012 BROAD ST, BLOOMFIELD, NJ 07003-2807
(973) 338-1244
Mailing address
90 FORSYTHIA LN, PARAMUS, NJ 07652-4334
(201) 575-5001
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05879200
NJ
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
10/27/2019
Last updated
01/24/2020
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