Individual
MRS. ANNIE LAVERNE CUMMINGS SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3801 COMPUTER DR, SUITE 112, RALEIGH, NC 27609-6506
(919) 720-8461
(888) 235-4554
Mailing address
104 EMERALD GLADE CT, GARNER, NC 27529-3771
(919) 720-8461
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8621
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6104857
—
NC
Enumeration date
06/29/2011
Last updated
03/04/2015
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