Individual
MRS. THERESA SHIELDS ZODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
6002 W BROAD ST, SUITE 203, RICHMOND, VA 23230-2213
(804) 257-5488
Mailing address
6002 W BROAD ST, SUITE 203, RICHMOND, VA 23230-2213
(804) 257-5488
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0904002711
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
231190
BCBS ID
VA
Enumeration date
02/09/2007
Last updated
07/08/2007
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