Individual
REBECCA SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2554 PALMER PARK BLVD, COLORADO SPRINGS, CO 80909-3058
(719) 634-1851
Mailing address
2554 PALMER PARK BLVD, COLORADO SPRINGS, CO 80909-3058
(719) 634-1851
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99687569
—
CO
Enumeration date
06/20/2016
Last updated
06/20/2016
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