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Ms. Shaverence Lawanda Outlaw, LRT/CTRS
Recreation Therapist in Winston Salem, North Carolina
NPI 1194356170

Shaverence Lawanda Outlaw is a Recreation Therapist based in Winston Salem, NC. Shaverence Lawanda Outlaw practices in Winston Salem, NC and has the professional credentials of LRT/CTRS. The NPI Number for Shaverence Lawanda Outlaw is 1194356170 and holds a License No. 3879 (North Carolina).

The current practice location address for Shaverence Lawanda Outlaw is 3890 Old Vineyard Rd Apt 86B, Winston Salem, NC and can be reached out via phone at 336-604-4537.

Location: 3890 Old Vineyard Rd Apt 86B, Winston Salem, NC, 27103-1368
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194356170
Provider Name
Shaverence Lawanda Outlaw
Credential
LRT/CTRS
Provider Entity Type
Individual
Gender
Female
Address
3890 Old Vineyard Rd Apt 86B, Winston Salem, NC, 27103-1368
Phone Number
336-604-4537
Fax Number
Provider Enumeration Date
01/29/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3879 01 NC NCBRTL
80617 01 CTRS
institution
Provider Business Practice Location Address Details
Address
3890 Old Vineyard Rd Apt 86B
City
Winston Salem
State
North Carolina
Zip
27104-4880
Phone Number
336-604-4537
Fax Number
person
Provider Business Mailing Address Details
Address
3890 Old Vineyard Rd Apt 86B
City
Winston Salem
State
North Carolina
Zip
27104-4880
Phone Number
336-604-4537
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Recreation Therapist
Speciality
-
Taxonomy
225800000X
License No.
3879 (North Carolina)
Definition
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.
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