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General NPI Number Information
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NPI Number | 1326597865
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Entity Type | Individual
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Provider Name | SHA'NEQUA LENNON
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Gender | Female
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Dates
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Enumeration Date | 09/26/2016
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 6799 NEXUS CT SUITE 103
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City | FAYETTEVILLE
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State | NC
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Zip | 28404
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Country | US
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Telephone | 910-672-6432
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Fax |
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Provider Business Mailing Address
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Address Line | 731 TILGHMAN DR
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City | DUNN
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State | NC
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Zip | 28334-5507
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Country | US
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Telephone | 910-574-7559
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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 | P010898
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License Number State | NC
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