Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003159914 |
---|---|
Provider Name | Shannon Price |
First Address | Concord, NC 28025 |
Second Address | North Wilkesboro, NC 28659-3551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2013 |
Last Update Date | 28/03/2013 |