Individual
CRYSTAL SHEPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
821 E MAIN ST, APT B-6, RIVERHEAD, NY 11901-2500
(631) 512-6523
Mailing address
821 E MAIN ST, APT B-6, RIVERHEAD, NY 11901-2500
(631) 512-6523
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
094468
NY
104100000X
Social Worker
—
—
Other
Enumeration date
12/11/2013
Last updated
03/17/2015
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