Individual
CINDY ANN SHAW-WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCADC
Contact information
Practice address
5124 GREENWICH AVE, BALTIMORE, MD 21229-2314
(410) 433-5255
(410) 234-0844
Mailing address
5124 GREENWICH AVE, BALTIMORE, MD 21229-2314
(410) 433-5255
(410) 234-0844
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCA216
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19524389624
—
MD
05
—
212150600
—
MD
Enumeration date
07/21/2008
Last updated
10/12/2015
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