Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 0810005431 | VA |
Y | 103TC0700X | Clinical Psychologist | 0810005431 | VA |
NPI | 1003181165 |
---|---|
Provider Name | Robin Douglas Shaw |
First Address | Atkins, VA 24311-3096 |
Second Address | Atkins, VA 24311-2214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2012 |
Last Update Date | 16/08/2016 |