Individual
MS. ELLEN M SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
129 B E 71 ST, NEW YORK, NY 10021
(212) 794-4782
(212) 861-3407
Mailing address
129 B E 71 ST, NEW YORK, NY 10021
(212) 794-4782
(212) 861-3407
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PR0122851
NY
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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