Individual
BRYAN SHEPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
520 S WALNUT ST, BLOOMINGTON, IN 47401-4618
(812) 502-4100
(812) 502-4200
Mailing address
520 S WALNUT ST # 3126, BLOOMINGTON, IN 47401-4618
(812) 502-4100
(812) 502-4200
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34008606A
IN
Other
Enumeration date
08/06/2015
Last updated
11/23/2021
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