Individual
RACHEL MARIE SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-1000
Mailing address
PO BOX 30180, SALT LAKE CITY, UT 84130-0180
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10376443-4201
UT
Other
Enumeration date
06/13/2017
Last updated
09/16/2019
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