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Individual

MR. KANTRELL DESHAWN SHELTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCAS

Contact information

Practice address
112 E ELWOOD AVE, RAEFORD, NC 28376-2921
(910) 848-1924
(910) 848-1928
Mailing address
2959 DALMATION DR, HOPE MILLS, NC 28348-4004
(910) 263-9570

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3029A
NC

Other

Enumeration date
11/28/2012
Last updated
07/14/2015
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