Organization
GROUPWORKS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TONY LEE SHEPPARD PSYD (PRESIDENT)
(502) 893-4042
Entity
Organization
Contact information
Practice address
2915 FRANKFORT AVE, STE. A, LOUISVILLE, KY 40206-2682
(502) 893-4042
(502) 893-4043
Mailing address
2915 FRANKFORT AVE, STE. A, LOUISVILLE, KY 40206-2682
(502) 893-4042
(502) 893-4043
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
KY1324
KY
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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