Individual
KORTNEY SHAKIA WATFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
607 WASHINGTON ST, WILLIAMSTON, NC 27892-2645
(252) 792-8035
Mailing address
607 WASHINGTON ST, WILLIAMSTON, NC 27892-2645
(252) 792-8035
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
A15682
NC
Other
Enumeration date
06/01/2020
Last updated
06/01/2020
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