Individual
RAEGAN CHRISTINE SHACKELFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
340 MENDEL PKWY W, MONTGOMERY, AL 36117-5406
(334) 532-0220
Mailing address
591 SHACKLEFORD LN, AUTAUGAVILLE, AL 36003-3005
(334) 544-9964
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5748
AL
Other
Enumeration date
01/27/2022
Last updated
01/27/2022
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