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General NPI Number Information
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NPI Number | 1770448052
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Entity Type | Individual
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Provider Name | EMILY DANIELLE SHAW
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Gender | Female
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 14426 MEDICAL COMPLEX DR
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City | TOMBALL
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State | TX
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Zip | 77377-6434
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Country | US
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Telephone | 281-205-2481
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Fax |
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Provider Business Mailing Address
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Address Line | 16114 CASTLEGROVE CT
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City | TOMBALL
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State | TX
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Zip | 77377-8521
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Country | US
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Telephone | 281-205-2481
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB1438045
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License Number State | TX
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