Individual
EDNA SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
8330 LAKEWOOD RANCH BLVD, LAKEWOOD RANCH, FL 34202-5174
(207) 344-4239
Mailing address
7543 42ND CT E, SARASOTA, FL 34243-3466
(207) 344-4239
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA.3469 OTA
SC
224Z00000X
Occupational Therapy Assistant
Primary
OTA17074
FL
Other
Enumeration date
06/11/2015
Last updated
08/23/2021
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