Organization
SHIELDS THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES SHIELDS LPC (SOLE MEMBER)
(479) 443-5575
Entity
Organization
Contact information
Practice address
1 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1825
(479) 443-5575
(479) 443-9554
Mailing address
1 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1825
(479) 443-5575
(479) 443-9554
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P0501003
AR
Other
Enumeration date
12/20/2013
Last updated
12/20/2013
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