Individual
MS. MARIEL D SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
3847
MA
225X00000X
Occupational Therapist
Primary
13188
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S70310410
DRIVERS LICENSE
MA
Enumeration date
11/04/2014
Last updated
09/07/2021
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