Individual
DESTIN SHORTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1970 ROANOKE BLVD, SALEM, VA 24153-6404
(540) 982-2463
Mailing address
4 BREWER ST APT 1, JAMAICA PLAIN, MA 02130-4054
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
Other
Enumeration date
03/09/2026
Last updated
03/09/2026
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