Provider Demographics
NPI:1467787945
Name:CARTER, SHEMA PHILISTINES
Entity type:Individual
Prefix:MS
First Name:SHEMA
Middle Name:PHILISTINES
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 FAIRMONT CIR
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28083-7819
Mailing Address - Country:US
Mailing Address - Phone:704-502-0335
Mailing Address - Fax:
Practice Address - Street 1:149 FAIRMONT CIR
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-7819
Practice Address - Country:US
Practice Address - Phone:704-502-0335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC09761225700000X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional