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MICHELE-ANN COLENA SHAW MS,CCC-SLP

>> Speech-Language Pathologist >> Speech, Language and Hearing Service Providers

Registrant NPI Number: 1811335912

Individual Registrant:
 MICHELE-ANN COLENA SHAW MS,CCC-SLP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
257 SW PIONEER WAY  FORT WHITE, FL 32038-3948 US
Tel: 386-497-4326  Fax: --

Contact information for business:
257 SW PIONEER WAY  FORT WHITE, FL 32038-3948 US
Tel: 386-497-4326  Fax: --

Registration Information:
NPI: 1811335912
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y235Z00000XSpeech, Language and Hearing Service Providers
Speech-Language Pathologist
FLSA6925

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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