Individual
LEONARD SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
6216 S LEWIS AVE STE 180, TULSA, OK 74136-1077
(918) 812-6010
Mailing address
4300 ROGERS AVE STE 20, FORT SMITH, AR 72903-3152
(479) 276-8871
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
OK
164W00000X
Licensed Practical Nurse
Primary
4703084481
MI
164W00000X
Licensed Practical Nurse
L046364
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200698990 A
—
OK
Enumeration date
08/09/2014
Last updated
04/18/2017
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