NPI 1205976099

Susan L Shackelford, PHD & Associates, PA

Organisation Clinical Psychologist Fayetteville, AR

Practice location

Address: 1 W Sunbridge Dr, Fayetteville, AR 72703-1825
Phone: (479) 443-5575
Fax: (479) 443-9554

Authorised official

Name: Lavonna M Latta
Title: Office Manager
Phone: (479) 443-5575

Registered specialties

Clinical Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence 97-04P (AR)

Other Psychologist providers in Arkansas →

Registry record

NPI: 1205976099
Entity type: Organization
NPI issued: 8 Feb 2007
Record last updated: 14 Apr 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.