Individual
JESSICA R. SHOCKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 N 6TH ST APT 3, LAFAYETTE, IN 47904-4033
(765) 414-8076
(765) 428-8040
Mailing address
1000 N 6TH ST APT 3, LAFAYETTE, IN 47904-4033
(765) 414-8076
(765) 428-8040
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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