Individual
MS. IRENE ROSE SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
700 LILLY RD NE, OLYMPIA, WA 98506-5115
(360) 923-7700
Mailing address
5904 BALUSTRADE BLVD SE, LACEY, WA 98513-5075
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL 60599108
WA
235Z00000X
Speech-Language Pathologist
SA 10496
FL
Other
Enumeration date
04/14/2011
Last updated
01/26/2016
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