Individual
ELIZABETH A. SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
112 SWIFT AVE, DURHAM, NC 27705-4883
(919) 824-2480
(919) 416-1188
Mailing address
112 SWIFT AVE, DURHAM, NC 27705-4883
(919) 824-2480
(919) 416-1188
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1107
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04534
BLUE CROSS BLUE SHIELD
NC
Enumeration date
11/16/2005
Last updated
11/16/2011
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