Individual
LYNDA SHACKLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP-CCC
Contact information
Practice address
22386 BUNCO CT, RAPID CITY, SD 57701-8422
(605) 415-3611
Mailing address
22386 BUNCO CT, RAPID CITY, SD 57701-8422
(605) 415-3611
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
316-SLP
SD
Other
Enumeration date
01/16/2015
Last updated
01/16/2015
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