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Individual

DR. KEVIN B SHACKET

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
3298 SUMMIT BLVD, BLDG 22, SUITE D1, PENSACOLA, FL 32503-8313
(850) 977-9215
(850) 662-0511
Mailing address
3298 SUMMIT BLVD, SUITE 22, ROOM D1, PENSACOLA, FL 32503-8313
(321) 303-9593

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY10532
FL

Other

Enumeration date
10/28/2019
Last updated
04/21/2026
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