Individual
JAYNE TYSON SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5372B OLD VIRGINIA ST, URBANNA, VA 23175-2179
(804) 758-5250
Mailing address
911 REISINGERS RD, WARSAW, VA 22572-3109
(804) 333-6319
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119000461
VA
Other
Enumeration date
02/26/2018
Last updated
02/26/2018
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