Maureen A Shaw, MS, ATC, LMT
Massage Therapist in Lake Mary, FL. Individual provider (NPI-1).
NPI number1679666184
StatusActive
Last updated in NPPESMay 28, 2009
Details
- NPI
- 1679666184
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Maureen A Shaw
- Credential
- MS, ATC, LMT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 2, 2006
- Last updated
- May 28, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | MA34636 | FL | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AL1326 | FL |
Practice location
3577 Lake Emma RdSuite 109
Lake Mary, FL 32746-2056
Phone 407-936-0314 · Fax 407-936-0316
Mailing address
2697 Bellewater PlaceOviedo, FL 32765
Phone 407-923-5495 · Fax 928-223-0264
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