Individual
SOPHIA SHEPPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 BRIGGS RD STE 280, MOUNT LAUREL, NJ 08054-4104
(856) 955-0811
(484) 231-8631
Mailing address
7 MEADOWRUE LN, SICKLERVILLE, NJ 08081-1959
(609) 432-5929
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-69996
NJ
106S00000X
Behavior Technician
RBT-21-191043
NJ
Other
Enumeration date
10/21/2022
Last updated
12/19/2023
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