| NPI | 1336408129 |
|---|---|
| Former Name | HEATHER SHELANA SHACKET |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA A127086) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A127086) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2023-07-21 |