Individual
BRITTAINY SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPP
Contact information
Practice address
312 S 4TH ST STE 700, LOUISVILLE, KY 40202-3046
(614) 390-3387
(614) 408-8892
Mailing address
312 S 4TH ST STE 700, LOUISVILLE, KY 40202-3046
(614) 390-3387
(614) 408-8892
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0835
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000502475
ANTHEM BCBS
—
05
—
30610026
—
KY
Enumeration date
09/21/2006
Last updated
06/17/2019
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