Individual
REBEKAH CONLISK SHOUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCA
Contact information
Practice address
8007 N POINT BLVD STE 209, WINSTON SALEM, NC 27106-3268
(866) 700-1606
(866) 338-5921
Mailing address
506 BROOKFIELD DR, GIBSONVILLE, NC 27249-3346
(704) 493-8665
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A15319
NC
101YP2500X
Professional Counselor
Primary
A15319
NC
Other
Enumeration date
11/21/2019
Last updated
11/21/2019
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