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Individual

SUSAN J SHEPHERD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
22 WHIPPLE ST, BRATTLEBORO, VT 05301-6080
(802) 254-5497
Mailing address
22 WHIPPLE ST, BRATTLEBORO, VT 05301-6080
(802) 254-5497

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890000448
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08028628
BCBS
05
1007083
VT
Enumeration date
10/03/2006
Last updated
07/08/2007
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