Outlaw, Shaverence Lawanda
Outlaw, Shaverence Lawanda is an sole proprietor health care provider with primary practice located at 3890 Old Vineyard Rd Apt 86B , Winston Salem NC 27104-4880. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Recreation Therapist, which is considered as her primary health care specialty. Outlaw, Shaverence Lawanda can be contacted via phone (336) 604-4537.Contact Information
Primary practice address
3890 Old Vineyard Rd Apt 86B
Winston Salem NC 27104-4880
Phone: (336) 604-4537
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Recreation Therapist | 225800000X | 3879 | North Carolina |
Profile Details
| NPI number | 1194356170 |
|---|---|
| LBN Legal business name | Outlaw, Shaverence Lawanda |
| Credentials | LRT/CTRS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 29th, 2020 |
| Last updated | Sep 16th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194356170 | NPPES |
| North Carolina | Other | 3879 | NCBRTL |
| North Carolina | Other | 80617 | NCBRTL |
Popular Providers
-
Wipperman, Jean L
508 Fulton St Pm&Rs 117, Durham NC 27705-3875 -
Mack, Evelyn Gil
13000 Bruce B Downs Blvd Rt117, Tampa FL 33612-4745 -
Jett, Carron
6439 Garners Ferry Rd , Columbia SC 29209-1638 -
Foster, Julie A.
211 N Homer Ln , Wolcott IN 47995-8077 -
Hobbs, Tracie Diane
3333 Silas Creek Pkwy , Winston Salem NC 27103-3013 -
Johnston, Heidi J
3915 Golden Valley Rd Courage Center, Minneapolis MN 55422-4249 -
Middlekauff, Lydia F
400 Veterans Ave , Biloxi MS 39531-2410 -
Caley, Morgan
3015 Limited Ln Nw Suite B, Olympia WA 98502-2638