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Individual

MRS. BETTY-SHANNON PREVATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., LPA

Contact information

Practice address
2601 LAKE DR, SUITE 103, RALEIGH, NC 27607-6688
(919) 612-3348
(919) 782-1399
Mailing address
115 MARSHFIELD PL, CARY, NC 27513-4972
(919) 612-3348
(919) 782-1399

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2425
NC

Other

Enumeration date
05/21/2007
Last updated
04/16/2008
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