Individual
DR. BRUCE WARNER SHACKLETON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
35 MAIN STREET #3, WAYLAND, MA 01778
(508) 655-6322
(508) 655-9793
Mailing address
POST OFFICE BOX 5232, WAYLAND, MA 01778
(508) 655-6322
(508) 655-9793
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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