Individual
MIKA MARIE SHEPPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 20TH ST, HUNTINGTON, WV 25703-1850
(304) 696-8700
(304) 696-8701
Mailing address
800 20TH ST, HUNTINGTON, WV 25703-1850
(304) 696-8700
(304) 696-8701
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
21484
WV
Other
Enumeration date
10/04/2022
Last updated
10/04/2022
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