Individual
SHANTA KITT FARMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4025 COLLEGIATE AVE APT D1, CHARLOTTE, NC 28262-8173
(704) 361-0851
Mailing address
4025 COLLEGIATE AVE APT D1, CHARLOTTE, NC 28262-8173
(704) 361-0851
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Enumeration date
11/16/2021
Last updated
11/16/2021
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