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Shara Lisette Laccone

NPI Registration Record

Provider / OrganizationNPIDate Certified
SHARA LISETTE LACCONE13165455852020-10-11
Entity TypeIndividual
Provider Name Shara Lisette Laccone
Practice Office Address117 HIDDEN VALLEY DR
CHAPEL HILL, NC US
Practice Office Telephone9128829293
Mailing Address488 BEACON RIDGE BLVD
CHAPEL HILL, NC 275169820 US
Business Telephone9128829293
HPT Codes
CodeLicense NoState
2084P0804X PRIMARY5013447 NC
OPI Codes

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