Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013338383 |
---|---|
Provider Name | Mr. Maxwell Routon Shaw |
First Address | Denver, CO 80231-3462 |
Second Address | Denver, CO 80231-3462 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2014 |
Last Update Date | 03/01/2014 |