Provider Demographics
NPI:1073292389
Name:SHAW, MOLLY SWATKINS (MS- CFY-SLP)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:SWATKINS
Last Name:SHAW
Suffix:
Gender:F
Credentials:MS- CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W WILLIAM CANNON DR STE 804
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5349
Mailing Address - Country:US
Mailing Address - Phone:512-733-9541
Mailing Address - Fax:855-941-2551
Practice Address - Street 1:2500 W WILLIAM CANNON DR STE 804
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5349
Practice Address - Country:US
Practice Address - Phone:512-733-9541
Practice Address - Fax:855-941-2551
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist