Individual
ABEGAIL SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
12563 VILLAGE CIRCLE DR, SAINT LOUIS, MO 63127-1758
(314) 270-7700
Mailing address
2945 CARRON RD, FESTUS, MO 63028-3556
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2020009205
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020009205
COTAL
MO
Enumeration date
08/10/2022
Last updated
08/10/2022
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