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Individual
DEVONA LYNN SHEPARD
Active
Individual
DEVONA LYNN SHEPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
519197
OR
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
528731
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6898
—
OR
Enumeration date
11/05/2020
Last updated
12/31/2020
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