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NPI 1316919921

NPI 1316919921 : KATHY M. SHELTON-RIEK MSW, ED.S. : SALISBURY, NC

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General NPI Number Information
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    NPI Number           |    1316919921
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    Entity Type          |    Individual 
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    Provider Name        |    KATHY M. SHELTON-RIEK MSW, ED.S.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/07/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    420 STATESVILLE BLVD 
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    City                 |    SALISBURY
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    State                |    NC
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    Zip                  |    28144-2318
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    Country              |    US
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    Telephone            |    704-639-9889
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1986 
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    City                 |    SALISBURY
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    State                |    NC
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    Zip                  |    28145-1986
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    Country              |    US
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    Telephone            |    704-639-9889
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    001524
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    License Number State |    NC
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