Individual
KATHLEEN SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
622 W COLLEGE AVE STE 2, SAINT MARIES, ID 83861-1822
(205) 245-4363
(208) 245-4349
Mailing address
622 W COLLEGE AVE STE 2, SAINT MARIES, ID 83861-1822
(205) 245-4363
(208) 245-4349
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-28880
ID
Other
Enumeration date
07/16/2008
Last updated
02/26/2015
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