Individual
MRS. JUDITH AMBER SHACKLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
100 ENVOY CIR UNIT 101, LOUISVILLE, KY 40299-1807
(502) 896-5669
Mailing address
8323 REGENCY WOODS WAY, LOUISVILLE, KY 40220-3817
(502) 548-1209
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
134527
KY
Other
Enumeration date
10/23/2019
Last updated
10/23/2019
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