Provider Demographics
NPI:1609085166
Name:SHIELDS, AUBREY ELIZABETH (OTRL)
Entity Type:Individual
Prefix:MRS
First Name:AUBREY
Middle Name:ELIZABETH
Last Name:SHIELDS
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:MISS
Other - First Name:AUBREY
Other - Middle Name:ELIZABETH
Other - Last Name:TOWNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:118 RED FOX CT
Mailing Address - Street 2:
Mailing Address - City:CLARKS HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29821-2112
Mailing Address - Country:US
Mailing Address - Phone:803-279-3214
Mailing Address - Fax:
Practice Address - Street 1:1110 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4216
Practice Address - Country:US
Practice Address - Phone:864-227-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2848225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist