Most Relevant Information
Provider Data
| NPI Number: | 1003407792 |
| Provider Name: | RYAN SHAW |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/27/2021 |
| Last Updated: | 01/27/2021 |
Provider Practice Location
400 E PRATT ST
BALTIMORE
MD
212023116
Practice Location Phone/Fax
| Phone: | 8866254740 |
| Fax: |
Provider Mailing Location
3309 4TH ST SE UNIT E
WASHINGTON
DC
200325459
Provider Mailing Phone/Fax
| Phone: | 2403517074 |
| Fax: |