Shadwell, Michael Stuart

Shadwell, Michael Stuart is an individual health care provider with primary practice located at 3814 Wilmington Ave , Saint Louis MO 63116-3221. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as his primary health care specialty. Shadwell, Michael Stuart can be contacted via phone (312) 420-9119.

Contact Information

Primary practice address
3814 Wilmington Ave Saint Louis MO 63116-3221
Phone: (312) 420-9119
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X RBT-19-89344 Missouri

Profile Details

NPI number 1376192849
LBN Legal business name Shadwell, Michael Stuart
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2019
Last updated Sep 8th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376192849 NPPES
Missouri Other R181353039 DRIVERS LICENSE

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