Individual
SHEENA ILEAN HASTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCASA
Contact information
Practice address
1807 E INNES ST, SALISBURY, NC 28146-6030
(704) 633-3616
Mailing address
665 W 4TH ST, WINSTON SALEM, NC 27101-2701
(336) 725-8389
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
28287
NC
Other
Enumeration date
11/07/2007
Last updated
03/28/2018
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