Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 13260 | NC |
N | 101Y00000X | Counselor | A13260 | NC |
NPI | 1003160946 |
---|---|
Provider Name | Ms. Kathryn Everett Shanks |
First Address | Asheville, NC 28801-2330 |
Second Address | Asheville, NC 28801-2330 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2012 |
Last Update Date | 19/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13260 | LCMHC LICENSE NUMBER (01) | NC |