Individual
COLBY LUISE DESHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 MACKENAN DR, CARY, NC 27511-7903
(919) 371-2848
Mailing address
537 WINSTON ST, CHARLOTTE, NC 28206-2562
(919) 720-0367
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/26/2024
Last updated
02/26/2024
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