Provider Demographics
NPI:1730302282
Name:SHIELDS, CLAUDIA (STUDENT AND HEALTHCA)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:
Last Name:SHIELDS
Suffix:
Gender:F
Credentials:STUDENT AND HEALTHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 867
Mailing Address - Street 2:105 WEST 100 NORTH FOUR CORNERS COMMUNITY BEHAVIORAL HE
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501
Mailing Address - Country:US
Mailing Address - Phone:435-637-7200
Mailing Address - Fax:435-637-2377
Practice Address - Street 1:45 EAST 100 SOUTH
Practice Address - Street 2:
Practice Address - City:CASTLE DALE
Practice Address - State:UT
Practice Address - Zip Code:84513
Practice Address - Country:US
Practice Address - Phone:435-259-2432
Practice Address - Fax:435-256-5369
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator