Individual
CHRISTINE SHEPHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
85 BULLDOG BLVD, MELBOURNE, FL 32901-3319
(561) 790-1191
Mailing address
262 NABBLE AVE NW, PALM BAY, FL 32907-2837
(321) 243-3831
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW13322
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RJ468
HFMG MA
FL
Enumeration date
05/14/2019
Last updated
08/28/2023
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