Individual
MATTHEW SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA CCC-SLP
Contact information
Practice address
35 CLAYTON CT, WOODBRIDGE, NJ 07095-1934
(732) 540-5577
Mailing address
1162 ST. GEORGE'S AVENUE PMB #278, PMB #278, AVENEL, NJ 07001
(732) 540-5577
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS00819000
NJ
Other
Enumeration date
07/27/2017
Last updated
07/27/2017
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