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Individual

KATHY SHEPHERD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1255 BRICE BLVD, BARTOW, FL 33830-6735
(863) 519-8233
(863) 519-8304
Mailing address
1290 GOLFVIEW AVE, BARTOW, FL 33830-6703
(863) 519-7900
(863) 519-7696

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009975500
FL
Enumeration date
04/16/2015
Last updated
04/16/2015
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