Individual
SHANICE HACKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
10910 CLARKSVILLE PIKE, ELLICOTT CITY, MD 21042-6106
(410) 313-6600
Mailing address
10910 CLARKSVILLE PIKE, ELLICOTT CITY, MD 21042-6106
(410) 313-6600
Taxonomy
Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
22031
MD
Other
Enumeration date
03/10/2019
Last updated
04/29/2026
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