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NPI Code Detail

MEDICARE: MS. CHIQUITA SHIELDS TCADC

MEDICARE: MS. CHIQUITA SHIELDS TCADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor278768KY

General Provider Information

NPI Number : 1184350050
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHIQUITA SHIELDS TCADC
Provider Business Mailing Address
First Line : 1365 DEVONPORT DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-1552
Country : US
Telephone Number : 859-309-2240
Fax Number :
Provider Business Practice Location Address
First Line : 1365 DEVONPORT DR
Second Line :
City : LEXINGTON
State : KY
Zip : 40504-1552
Country : US
Telephone Number : 859-309-2240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2022
Last Update Date : 07/25/2022

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Directions to “ MS. CHIQUITA SHIELDS TCADC” Practice Location

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