Individual
ASHLEY L SHACKELFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
322 E DURHAM ST APT I, PHILADELPHIA, PA 19119-1221
(267) 476-0218
Mailing address
322 E DURHAM ST APT I, PHILADELPHIA, PA 19119-1221
(267) 476-0218
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH004463
PA
Other
Enumeration date
08/03/2019
Last updated
08/03/2019
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