Shackford, Shane

Shackford, Shane is an sole proprietor health care provider with primary practice located at 325 E Jimmie Leeds Rd Suite 182, Galloway NJ 08205-4126. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Shackford, Shane can be contacted via phone (609) 325-8775.

Contact Information

Primary practice address
325 E Jimmie Leeds Rd Suite 182 Galloway NJ 08205-4126
Phone: (609) 325-8775
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 2516 New Jersey

Profile Details

NPI number 1134405533
LBN Legal business name Shackford, Shane
Credentials PSY.D
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 29th, 2011
Last updated Oct 29th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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