Individual
CRYSTAL LAUREN SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1100 HIDDEN VALLEY DR, ROUND ROCK, TX 78665-1565
(512) 576-5909
Mailing address
4005 BANISTER LN, AUSTIN, TX 78704-8077
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
08/13/2018
Last updated
08/13/2018
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