Individual
LATISHA ANGELA SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6344 E BROWN RD STE 104, MESA, AZ 85205-4843
(480) 269-0765
Mailing address
3353 E WINDSOR DR, GILBERT, AZ 85296-7393
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/18/2023
Last updated
08/18/2023
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