| Doctor Name: | MRS. BETTY-SHANNON PREVATT |
| NPI Number: | 1003025685 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., LPA |
| License Number: | 2425 |
| Business Practice Address: | 2601 Lake Dr Suite 103 Raleigh, NC - 276076688 |
| Business Phone Number: | 9196123348 |
| Business Fax Number: | 9197821399 |
| Mailing Address: | 115 Marshfield Pl, CARY |
| State: | NC |
| Postal Code: | 275134972 |
| Phone Number: | 9196123348 |
| Fax Number: | 9197821399 |
| NPI Enumeration Date: | 05/21/2007 |
| NPI Last Update Date: | 04/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2425 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |