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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 12 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.

Request for update

Popular Providers