Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 7308 | NC |
Y | 101YP2500X | Professional Counselor | S7308 | NC |
N | 225C00000X | Rehabilitation Counselor | 00101339 | NC |
NPI | 1184802266 |
---|---|
Provider Name | Shana Renee Gordon-Cole |
First Address | Greensboro, NC 27408-7035 |
Second Address | Greensboro, NC 27408-7035 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2008 |
Last Update Date | 10/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1184802266 | NPI (01) | |
6104221 | (05) | NC |