Individual
CHARLES H SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
THERAPIST
Contact information
Practice address
2003 SE WALTON BLVD, BENTONVILLE, AR 72712-3725
(479) 464-5925
(479) 521-6520
Mailing address
3352 N FUTRALL DR, FAYETTEVILLE, AR 72703-4057
(479) 521-5731
(479) 521-6520
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/23/2008
Last updated
10/23/2008
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