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Individual

MARY SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
14802 W WIGWAM BLVD, GOODYEAR, AZ 85395-8231
(623) 932-7200
Mailing address
15753 W BERKELEY RD, GOODYEAR, AZ 85395-7110
(512) 557-8655

Taxonomy

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

Other

Enumeration date
01/13/2019
Last updated
01/13/2019
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