Individual
MR. GERALD SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CACI
Contact information
Practice address
180 WATER OAK DR, CEDARTOWN, GA 30125-2095
(770) 748-2225
Mailing address
269 KIKER ST, TALLAPOOSA, GA 30176-1340
(404) 809-7139
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3114
GA
Other
Enumeration date
12/04/2015
Last updated
12/04/2015
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