Provider Information for 1558009902
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SAVANNA SHACKELFORD LICSW
Sex: Female
NPI: 1558009902
Last Updated: 2022-05-25
Certification Date: 2022-05-25
Certification Date: 2022-05-25
Details
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NPI | 1558009902 | ||||||||
Enumeration Date | 2022-05-25 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 713 COVINGTON AVE BIRMINGHAM, AL 35206-3012 United States Phone: | Fax: | ||||||||
Primary Practice Address | 1401 20TH ST S BIRMINGHAM, AL 35205-4913 United States Phone: 205-580-3014 | Fax: | ||||||||
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