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Individual

EMMA SHACKLETON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
695 N PERRYVILLE RD STE 4, ROCKFORD, IL 61107-6225
(779) 368-0060
Mailing address
695 N PERRYVILLE RD STE 4, ROCKFORD, IL 61107-6225

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YP2500X
Professional Counselor
Primary
180.014466
IL

Other

Enumeration date
07/19/2018
Last updated
05/01/2023
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