Individual
DIAMOND DAWN SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
17004 NOVAK DR, HAZEL CREST, IL 60429-1156
(708) 739-6990
Mailing address
17004 NOVAK DR, HAZEL CREST, IL 60429-1156
(708) 739-6990
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227022203
IL
Other
Enumeration date
06/11/2022
Last updated
07/22/2022
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