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Individual

HERMAN RICHARD WANSHIYA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1940 DAISY ST, WINSTON SALEM, NC 27107-4304
(336) 529-3893
Mailing address
1940 DAISY ST, WINSTON SALEM, NC 27107-4304
(336) 529-3898

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
08/17/2022
Last updated
08/17/2022
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