Individual
BRANDY ELAINE SHIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2055 N PERRIS BLVD STE G, PERRIS, CA 92571-2509
(951) 674-5354
(951) 674-5227
Mailing address
PO BOX 549, LAKE ELSINORE, CA 92531-0549
(951) 674-5354
(951) 674-5227
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/23/2010
Last updated
04/23/2010
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