Individual
CYNTHIA SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
405 N WABASH AVE UNIT 2511, CHICAGO, IL 60611-5668
(312) 505-8858
Mailing address
405 N WABASH AVE UNIT 2511, CHICAGO, IL 60611-5668
(312) 505-8858
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.010599
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
071.010599
LICENSE
IL
Enumeration date
09/16/2021
Last updated
09/16/2021
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