Individual
ASHLEY JO SHACKELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1939 S DIVISION AVE, GRAND RAPIDS, MI 49507
(616) 247-3815
(616) 245-0450
Mailing address
1939 S DIVISION AVE, GRAND RAPIDS, MI 49507
(616) 247-3815
(616) 245-0450
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6801102222
MI
1041C0700X
Clinical Social Worker
Primary
6801108838
MI
Other
Enumeration date
10/08/2018
Last updated
04/22/2021
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