Individual
SHENTELLE MARIE LIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPA
Contact information
Practice address
1964 S MAIN ST, WAKE FOREST, NC 27587-9336
(919) 554-0177
(919) 554-0177
Mailing address
4705 UNIVERSITY DR BLDG 700, DURHAM, NC 27707-3489
(919) 237-1337
(866) 538-4716
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6658
NC
Other
Enumeration date
10/09/2024
Last updated
04/18/2025
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