Individual
SHANA GORDON WALTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LCMHC, CRC
Contact information
Practice address
5 OAK BRANCH DR STE H, GREENSBORO, NC 27407-2157
(336) 288-9190
(336) 450-4318
Mailing address
5 OAK BRANCH DR STE H, GREENSBORO, NC 27407-2157
(336) 288-9190
(336) 450-4318
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
S7308
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184802266
NPI
—
Enumeration date
01/31/2008
Last updated
08/26/2025
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