Individual
SHAINA M PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5109 KODIAK CT, CHARLOTTE, NC 28215-8734
(704) 281-8811
Mailing address
5109 KODIAK CT, CHARLOTTE, NC 28215-8734
(704) 281-8811
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
12/06/2024
Last updated
12/06/2024
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