MS. SHAVERENCE OUTLAW, LRT/CTRS

Recreation Therapist

Active Individual
NPI: 1194356170

Practice Address

3890 OLD VINEYARD RD APT 86B
Winston Salem, NC 27104

Phone: (336) 604-4537

Specialties

Specialty Code Primary License
Recreation Therapist 225800000X Yes 3879 (NC)

Frequently Asked Questions

NPI 1194356170 is the National Provider Identifier for MS. SHAVERENCE OUTLAW, LRT/CTRS, a Recreation Therapist provider located in Winston Salem, NC. This NPI was enumerated on January 29, 2020.
MS. SHAVERENCE OUTLAW, LRT/CTRS practices at 3890 OLD VINEYARD RD APT 86B, Winston Salem, NC 27104.

Quick Facts

NPI
1194356170
Type
Individual
Enumerated
Jan 29, 2020
Last Updated
Sep 16, 2021

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