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General NPI Number Information
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NPI Number | 1801161401
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Entity Type | Organization
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Legal Business Name | SHOALS FAMILY THERAPY, P.C
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Dates
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Enumeration Date | 03/14/2012
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Last Update Date | 03/27/2017
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Provider Practice Location Address
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Address Line | 2309 W CONE BLVD SUITE 202
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City | GREENSBORO
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State | NC
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Zip | 27408-4044
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Country | US
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Telephone | 336-317-7157
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Fax |
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Provider Business Mailing Address
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Address Line | 2309 W CONE BLVD SUITE 202
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City | GREENSBORO
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State | NC
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Zip | 27408-4044
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Country | US
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Telephone | 336-317-7157
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DREW JAMIESON
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Credential | PHD
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Telephone | 336-317-7157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1807
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1734
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License Number State | NC
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