Provider Information for 1063777696
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MYAMARIA SHIELDS MSW
Other Names:Former Name:MYAMARIA BOLDENSex: Female
NPI: 1063777696
Last Updated: 2025-02-28
Certification Date: 2025-02-28
Certification Date: 2025-02-28
Details
| Name | Value | ||||||||||||||||
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| NPI | 1063777696 | ||||||||||||||||
| Enumeration Date | 2012-07-10 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 3261 COMMERCIAL WAY SPRING HILL, FL 34606-2694 United States Phone: 352-686-3188 | Fax:352-686-9394 | ||||||||||||||||
| Primary Practice Address | 3261 COMMERCIAL WAY SPRING HILL, FL 34606-2694 United States Phone: 352-686-3188 | Fax: | ||||||||||||||||
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