Individual
REBECCA WILSON SHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAS-A
Contact information
Practice address
200 QUEENS RD STE 102, CHARLOTTE, NC 28204-3252
(704) 756-7688
Mailing address
2016 NOLEN PARK LN, CHARLOTTE, NC 28209-1565
(704) 756-7688
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCASA25106
NC
Other
Enumeration date
01/29/2019
Last updated
01/29/2019
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