Individual
SHELON VANESSA GAUL-BUNCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
4821 MIRANDA DR, HOPE MILLS, NC 28348-5674
(910) 551-5210
Mailing address
4821 MIRANDA DR, HOPE MILLS, NC 28348-5674
(910) 551-5210
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
P005232
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P005232
PROVISIONAL LICENSED CLINICAL SOCAL WORKER
NC
Enumeration date
10/19/2009
Last updated
10/19/2009
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