RUSSELL P SHIELDS

SANTA ROSA, CA
NPI1336385160
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date2008-12-29
Last Update Date2014-08-19
Business Address
RUSSELL P SHIELDS
1430 NEOTOMAS AVE
SANTA ROSA, CA 95405-7575
Phone number: 707-565-7460
Mailing Address
RUSSELL P SHIELDS
1430 NEOTOMAS AVE
SANTA ROSA, CA 95405-7575
Phone number: 707-565-7460
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