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Individual

SHELLY SHEPHERD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3221 REYNOLDS ST, LARAMIE, WY 82072-5077
(307) 703-0206
Mailing address
3321 REYNOLDS ST, LARAMIE, WY 82072-5094
(307) 703-0206

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-1135
WY
225X00000X
Occupational Therapist
042
WY

Other

Enumeration date
07/11/2016
Last updated
07/11/2016
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