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Individual

TARA SHIELDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1425 S LINDSAY RD UNIT 36, MESA, AZ 85204-6233
(480) 282-0320
Mailing address
1603 E ELMWOOD ST, MESA, AZ 85203-5810

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
434368
AZ

Other

Enumeration date
03/19/2020
Last updated
03/19/2020
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