Individual
SHANNON ELIZABETH KERSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPA
Contact information
Practice address
4425 RANDOLPH RD, SUITE 208, CHARLOTTE, NC 28211-2351
(704) 323-6586
Mailing address
4425 RANDOLPH RD, SUITE 208, CHARLOTTE, NC 28211-2351
(704) 323-6586
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
2531
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6107171
—
NC
Enumeration date
08/31/2006
Last updated
09/25/2012
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