Individual
CRISNEY SHEPPERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8332 S 525 W, WINAMAC, IN 46996-7651
(219) 204-3543
Mailing address
8332 S 525 W, WINAMAC, IN 46996-7651
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-21-196360
IN
Other
Enumeration date
03/12/2025
Last updated
03/12/2025
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