Individual
SHANTEL KIMBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4140 CHERRY ST, WINSTON SALEM, NC 27105-2536
(336) 306-9620
Mailing address
3939 COTTINGTON DR, WINSTON SALEM, NC 27105-4120
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/27/2020
Last updated
04/27/2020
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