Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 071.010669 | IL |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 071.010669 | IL |
N | 103G00000X | Clinical Psychologist | 071.010669 | IL |
N | 103TC0700X | Clinical Psychologist | 071.010669 | IL |
N | 103G00000X | Clinical Psychologist | 1311 | OK |
N | 103TC0700X | Clinical Psychologist | 1311 | OK |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 071.010669 | IL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1311 | OK |
N | 103TF0000X | Family Psychologist | 071.010669 | IL |
N | 103TH0004X | Health Psychologist | 071.010669 | IL |
N | 103TH0100X | Health Service | 1311 | OK |
N | 103TM1800X | Intellectual & Developmental Disabilities | 071.010669 | IL |
N | 103TM1800X | Intellectual & Developmental Disabilities | 1311 | OK |
N | 103TP2701X | Group Psychotherapist | ||
N | 103TP2701X | Group Psychotherapist | 071.010669 | IL |
NPI | 1417440173 |
---|---|
Provider Name | Dr. Paul Michael Shawler |
First Address | Carbondale, IL 62901-1290 |
Second Address | Carbondale, IL 62903-8362 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2018 |
Last Update Date | 05/01/2022 |