Individual
NICOLE SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7228 OLIVE COAST ST, CHARLOTTE, NC 28262-7078
(980) 785-1113
Mailing address
7228 OLIVE COAST ST, CHARLOTTE, NC 28262-7078
(919) 308-4481
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
1-18-74329
NC
Other
Enumeration date
03/27/2019
Last updated
02/28/2024
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