Most Relevant Information
Provider Data
| NPI Number: | 1003031253 |
| Provider Name: | MAKEBA SHARICE SHAW MA, LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: | 5591 |
Most Important Dates
| Enumeration Date: | 04/14/2007 |
| Last Updated: | 12/14/2009 |
Provider Practice Location
221 ELISHA DR
WILMINGTON
NC
284053855
Practice Location Phone/Fax
| Phone: | 9102330355 |
| Fax: | 9107996263 |
Provider Mailing Location
221 ELISHA DR
WILMINGTON
NC
284053855
Provider Mailing Phone/Fax
| Phone: | 9102330355 |
| Fax: | 9107996263 |