Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1094 | SC |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 3558 | NC |
NPI | 1033354923 |
---|---|
Provider Name | Dr. Karen Shelton |
First Address | Waxhaw, NC 28173-1381 |
Second Address | Charlotte, NC 28277-5703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2008 |
Last Update Date | 08/12/2008 |