Shaw, Candice Tyan
Shaw, Candice Tyan is an sole proprietor health care provider with primary practice located at 1000 St. Louis Street Suite 102, Fort Worth TX 76104. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is her primary health care specialty. Shaw, Candice Tyan can be contacted via phone (817) 921-5020.Contact Information
Primary practice address
1000 St. Louis Street Suite 102
Fort Worth TX 76104
Phone: (817) 921-5020
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X | 1-11-9504 | |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | 993772 |
Profile Details
| NPI number | 1811243074 |
|---|---|
| LBN Legal business name | Shaw, Candice Tyan |
| Credentials | OT, BCBA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 25th, 2012 |
| Last updated | Mar 7th, 2014 - about 10 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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