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NPI Code Detail

MEDICARE: HEATHER SHACKELFORD

MEDICARE: HEATHER SHACKELFORD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist7101002674MI

General Provider Information

NPI Number : 1669899126
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER SHACKELFORD
Provider Business Mailing Address
First Line : 5141 SILVERBERRY DR
Second Line :
City : MT PLEASANT
State : MI
Zip : 48858-5522
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1222 NORTH DR
Second Line :
City : MT PLEASANT
State : MI
Zip : 48858-3200
Country : US
Telephone Number : 989-992-8658
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2014
Last Update Date : 03/23/2014

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Directions to “ HEATHER SHACKELFORD ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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