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Individual

MS. RAVENN SHANNEL HACKNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
1913 LAMAR ST, DURHAM, NC 27705-3310
(919) 286-1509
Mailing address
1913 LAMAR ST, DURHAM, NC 27705-3310
(919) 286-1509

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
27572
NC

Other

Enumeration date
09/22/2021
Last updated
09/22/2021
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