Individual
SAMARA SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1306 S GLENWOOD BLVD, TYLER, TX 75701-2740
(806) 463-9948
Mailing address
1306 S GLENWOOD BLVD, TYLER, TX 75701-2740
(806) 463-9948
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
73938
TX
Other
Enumeration date
05/03/2022
Last updated
05/03/2022
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