Individual
JESSICA SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6330 N CENTER DR STE 200, NORFOLK, VA 23502-4008
(804) 562-6604
(757) 970-0277
Mailing address
6800 PARAGON PL STE 200, RICHMOND, VA 23230-1652
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-22-199979
VA
Other
Enumeration date
11/22/2022
Last updated
11/22/2022
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