SHAVERENCE LAWANDA OUTLAW

WINSTON SALEM, NC
NPI1194356170
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225800000X Recreation Therapist
(Licence: NC  3879)
Enumeration Date2020-01-29
Last Update Date2021-09-16
Business Address
Ms. SHAVERENCE LAWANDA OUTLAW LRT/CTRS
3890 OLD VINEYARD RD APT 86B
WINSTON SALEM, NC 27104-4880
Phone number: 336-604-4537
Mailing Address
Ms. SHAVERENCE LAWANDA OUTLAW LRT/CTRS
615 SAINT GEORGE SQUARE CT STE 300
WINSTON SALEM, NC 27103-1368
Phone number: 336-604-4537
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