Individual
CHANTEL DOMINIQUE SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1651 CROFTON BLVD STE 6, CROFTON, MD 21114-1314
(410) 888-0184
Mailing address
1500 S DOUGLAS RD, CORAL GABLES, FL 33134-4108
(844) 424-1818
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
MD10274198910
MD
Other
Enumeration date
02/09/2026
Last updated
02/11/2026
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