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Individual

DR. ROBERT J. SHEPPARD

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
5340 HOLIDAY TER, KALAMAZOO, MI 49009-2196
(269) 372-4140
(269) 372-0390
Mailing address
7151 CARLSBROOK LN, PORTAGE, MI 49024-4165
(269) 324-5027
(269) 372-0390

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301003402
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
120811
VALUE OPTIONS
MI
Enumeration date
11/15/2005
Last updated
07/08/2007
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