Individual
MS. SHAVONICA DIONNE STEVENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1910 MCKNIGHT MILL RD, GREENSBORO, NC 27405-3908
(336) 255-5576
Mailing address
322 CRAIG ST, GREENSBORO, NC 27406-2848
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
MHL-041-862
NC
Other
Enumeration date
06/25/2008
Last updated
06/25/2008
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