Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YP1600X | Pastoral Counselor |
NPI | 1053674960 |
---|---|
Provider Name | Ms. Victoria Lynn Shields |
First Address | Chapel Hill, NC 27517-2375 |
Second Address | Chapel Hill, NC 27517-2375 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2012 |
Last Update Date | 05/06/2014 |