Individual
MRS. ANGELA TAYLOR SHIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180005724
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02215643
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/18/2006
Last updated
07/08/2008
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