Individual
JACQUELINE SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23224-4915
(804) 675-5000
(804) 675-5308
Mailing address
1201 BROAD ROCK BLVD, RICHMOND, VA 23224-4915
(804) 675-5000
(804) 675-5308
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW005742
GA
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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