Individual
MICHAELA SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
600 N ROBBINS RD STE 100, BOISE, ID 83702-4539
(208) 381-9037
(208) 385-3616
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
12966160-2504
UT
103TC0700X
Clinical Psychologist
Primary
9871472
ID
Other
Enumeration date
09/14/2022
Last updated
10/31/2025
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