Individual
MS. EMILLY SHEPHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
218 S SOUTHWEST PLAZA CIR, INDIANOLA, MS 38751-3491
(662) 897-6408
Mailing address
PO BOX 1617, INDIANOLA, MS 38751-1617
(662) 897-6408
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
07/22/2021
Last updated
07/22/2021
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