Organization
GLORIA CRANDELL-NELSON
Active
Other names
Shadows Community Support Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLORIA CRANDELL-NELSON (CEO)
(252) 795-6662
Entity
Organization
Contact information
Practice address
7356 US HIGHWAY 64, ROBERSONVILLE, NC 27871-9073
(252) 795-6662
(252) 795-6696
Mailing address
7356 HWY 64 E, ROBERSONVILLE, NC 27871-0278
(252) 795-6662
(252) 795-6696
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5950083
—
NC
05
—
6006991
—
NC
05
—
8301939
—
NC
Enumeration date
04/09/2007
Last updated
07/20/2010
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