Doctor Name: | DR. CAROL ANN SHAVER |
NPI Number: | 1265551642 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | EDD |
License Number: | 6301006049 |
Business Practice Address: | 5722 St Joseph Avenue Stevensville, MI - 49127 |
Business Phone Number: | 2694294148 |
Business Fax Number: | 2694296878 |
Mailing Address: | 5722 St Joseph Avenue, STEVENSVILLE |
State: | MI |
Postal Code: | 49127 |
Phone Number: | 2694294148 |
Fax Number: | 2694296878 |
NPI Enumeration Date: | 03/28/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 6301006049 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |