Individual
DANIEL SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 BARR ST, FORT WAYNE, IN 46802-3502
(260) 802-0383
Mailing address
1200 BARR ST, FORT WAYNE, IN 46802-3502
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
14808528
IN
Other
Enumeration date
09/26/2024
Last updated
10/04/2024
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