Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 2546 | AL |
NPI | 1306039912 |
---|---|
Provider Name | Mrs. Catherine Merritt Shaw |
First Address | Daphne, AL 36526-4616 |
Second Address | Mobile, AL 36608-1183 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2007 |
Last Update Date | 03/05/2016 |