Individual
MRS. LAURA LEE RUDISILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC-S
Contact information
Practice address
215 S WASHINGTON ST STE 104, SHELBY, NC 28150-4675
(704) 482-2977
(704) 482-3501
Mailing address
1811 GREEN VALLEY DR, SHELBY, NC 28152-7639
(704) 482-2977
(704) 482-3501
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
3261
NC
101YP2500X
Professional Counselor
Primary
S3261
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1387Y
BCBS
NC
05
—
6102271
—
NC
Enumeration date
05/28/2005
Last updated
09/09/2020
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