Individual
RAVEN MICHAELA SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS MHA
Contact information
Practice address
1203 AMERICAN GREETING CARD RD, CORBIN, KY 40701-4811
(606) 528-7010
Mailing address
1585 KY 3437, GRAY, KY 40734-6548
(606) 344-0113
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/23/2019
Last updated
01/23/2019
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