Individual
DR. SHIRLEY F SHIFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD HSPP
Contact information
Practice address
8424 VICTORIA WOODS PL, FORT WAYNE, IN 46825-6510
(260) 489-0292
(260) 489-3060
Mailing address
8424 VICTORIA WOODS PL, FORT WAYNE, IN 46825-6510
(260) 489-0292
(260) 489-3060
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20040729
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100210420C
—
IN
01
—
P00249943
RAILROAD MEDICARE
IN
Enumeration date
02/28/2007
Last updated
08/16/2007
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