Individual
MS. KAYLYNN CARISSA SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
301 SCOTT AVE, MORGANTOWN, WV 26508-8804
(304) 296-1731
Mailing address
301 SCOTT AVE, MORGANTOWN, WV 26508-8804
(304) 296-1731
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
DP00939507
WV
Other
Enumeration date
02/13/2008
Last updated
02/13/2008
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