Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 1871 | NC |
Y | 103TC0700X | Clinical Psychologist | 1871 | NC |
NPI | 1003827064 |
---|---|
Provider Name | Mrs. Shelley T. Kraft |
First Address | Clayton, NC 27520-5507 |
Second Address | Raleigh, NC 27609-4389 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2006 |
Last Update Date | 08/07/2007 |