SHASTA GABRIELLE STATEN

CHARLOTTE, NC
NPI1124363718
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YP2500X Counselor, Professional
(Licence: NC  9182)
Enumeration Date2012-12-07
Last Update Date2021-06-23
Business Address
SHASTA GABRIELLE STATEN Med, LPC
5200 PARK RD STE 218B
CHARLOTTE, NC 28209-3650
Phone number: 866-700-1606
Mailing Address
SHASTA GABRIELLE STATEN Med, LPC
12664 PERSIMMON TREE DR
CHARLOTTE, NC 28273-8024
Phone number: 704-621-1095