Individual
MISS ALIVEA LEAHANN SHEPHERD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 E RUDISILL BLVD # B100, FORT WAYNE, IN 46806-1738
(260) 255-3665
Mailing address
107 HILLCREST DR, KENDALLVILLE, IN 46755-1925
(260) 585-9668
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/02/2026
Last updated
07/02/2026
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