Doctor Name: | SUSANNE L SHIELD |
NPI Number: | 1336540632 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MHC |
License Number: | 001557 |
Business Practice Address: | 1700 Park Ave Muscatine, IA - 527615469 |
Business Phone Number: | 5635064363 |
Business Fax Number: | |
Mailing Address: | 2906 Bonnie Dr, MUSCATINE |
State: | IA |
Postal Code: | 527612311 |
Phone Number: | 5635064363 |
Fax Number: | |
NPI Enumeration Date: | 09/06/2014 |
NPI Last Update Date: | 09/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 001557 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |