MS. SHAVERENCE LAWANDA OUTLAW LRT/CTRS NPI 1194356170

NPI Information

MS. Shaverence Lawanda Outlaw, LRT/CTRS is a recreation therapist in Winston Salem, NC. The provider is a recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. MS. Shaverence Lawanda Outlaw, LRT/CTRS NPI is 1194356170. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3890 OLD VINEYARD RD APT 86B
WINSTON SALEM, NC
ZIP 27104-880
Phone: (336) 604-4537

The enumeration date for this NPI number is 1/29/2020 and was last updated on 9/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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