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Individual

MIESHA SHINEAQUAH FREDERICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2643 CLYDESDALE TER, CHARLOTTE, NC 28208-4133
(704) 724-9394
Mailing address
2643 CLYDESDALE TER, CHARLOTTE, NC 28208-4133

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10674
SC
376K00000X
Nurse's Aide
570855
NC

Other

Enumeration date
11/24/2025
Last updated
11/25/2025
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