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1326399387
TERESA I SHACKELFORD
BOISE, ID
NPI
1326399387
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW-31375)
Enumeration Date
2012-09-30
Last Update Date
2012-09-30
Business Address
Ms. TERESA I SHACKELFORD LCSW
7275 W POTOMAC DR STE. A
BOISE, ID 83704-9150
Phone number: 208-284-0377
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Mailing Address
Ms. TERESA I SHACKELFORD LCSW
6263 W COHIBA LN
BOISE, ID 83703-2848
Phone number: 208-284-0377
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