Individual
MARY P SHEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1018 N BRAGG BLVD, SPRING LAKE, NC 28390-3316
(910) 916-8591
Mailing address
1018 N BRAGG BLVD, SPRING LAKE, NC 28390-3316
(910) 916-8591
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
RBT74562
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT74562
BACB
NC
Enumeration date
01/30/2019
Last updated
01/30/2019
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