Individual
SHANNON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
600 N ELM ST, HIGH POINT, NC 27262-4332
(336) 878-6915
Mailing address
103 MALL LOOP ROAD, HIGH POINT, NC 27262-4332
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
9617
NC
Other
Enumeration date
02/13/2017
Last updated
02/17/2017
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