Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 240 | OK |
NPI | 1457509739 |
---|---|
Provider Name | Dr. Catherine Jarvis Shaw |
First Address | Oklahoma City, OK 73104-5007 |
Second Address | Oklahoma City, OK 73104-5007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2008 |
Last Update Date | 29/08/2008 |