Individual
DR. PATRICIA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
225 S MERAMEC AVE, SUITE 506, SAINT LOUIS, MO 63105-3511
(314) 863-3588
(314) 863-0074
Mailing address
138 HOLLY GARDEN DR, BALLWIN, MO 63021-6531
(314) 863-3588
(314) 863-0074
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY01201
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
493257802
—
MO
Enumeration date
07/26/2006
Last updated
10/02/2019
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