Individual
TRAVIS MARTIN SHIVLEY-SCOTT
Active
Individual
TRAVIS MARTIN SHIVLEY-SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
32064
CA
103T00000X
Psychologist
32064
CA
103TC0700X
Clinical Psychologist
32064
CA
Other
Enumeration date
06/24/2021
Last updated
10/07/2022
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