Individual
LISA SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
309 S MADISON ST, EVANSVILLE, WI 53536-1323
(608) 882-5322
Mailing address
309 S MADISON ST, EVANSVILLE, WI 53536-1323
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3319-154
WI
Other
Enumeration date
12/31/2010
Last updated
12/31/2010
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