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1811086853
MARK ANTHONY SHIELDS
FAIRBANKS, AK
NPI
1811086853
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: AK 402)
Enumeration Date
2006-10-11
Last Update Date
2007-07-08
Business Address
Mr. MARK ANTHONY SHIELDS MSW, LCSW, ACSW
3504 INDUSTRIAL AVE
FAIRBANKS, AK 99701-7376
Phone number: 907-452-4673
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Mailing Address
Mr. MARK ANTHONY SHIELDS MSW, LCSW, ACSW
3504 INDUSTRIAL AVE PO BOX 70450
FAIRBANKS, AK 99701-7376
Phone number: 907-452-4673
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