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Individual

ADRIENNE SHIELDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.P.C.

Contact information

Practice address
3833 S TEXAS AVE STE 104, BRYAN, TX 77802-4000
(979) 315-4705
(979) 431-4963
Mailing address
3833 S TEXAS AVE STE 104, BRYAN, TX 77802-4000
(979) 315-4705
(979) 431-4963

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YM0800X
Mental Health Counselor
17668
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1525537-02
TX
Enumeration date
05/05/2006
Last updated
06/12/2024
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