Individual
MICHELE DEE SHACKELFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1430 2ND AVE, SUITE 103, NEW YORK, NY 10021-3313
(212) 434-4594
(212) 717-5691
Mailing address
420 E 54TH ST, APT. 33B, NEW YORK, NY 10022-5179
(917) 322-0455
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
005459
NY
Other
Enumeration date
01/04/2007
Last updated
07/08/2007
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