Individual
DR. BRUCE WARNER SHACKLETON
Active
Individual
DR. BRUCE WARNER SHACKLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2621
MA
103TC0700X
Clinical Psychologist
Primary
2621
MA
Other
Enumeration date
10/02/2006
Last updated
02/26/2010
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