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Individual

MS. VIVIAN TARVIN SHIELDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
263 FOREST VALLEY DR, JACKSON, MS 39212-3800
(601) 371-8937
Mailing address
263 FOREST VALLEY DRIVE, JACKSON, MS 39212
(601) 371-8937

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C0269
MS

Other

Enumeration date
01/29/2007
Last updated
07/08/2007
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