Individual
KALI L SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2817 NEW PINERY RD, PORTAGE, WI 53901-9240
(608) 745-6290
Mailing address
1515 PARK AVE, COLUMBUS, WI 53925-1618
(920) 623-2200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5263-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100027480
—
WI
Enumeration date
11/26/2012
Last updated
05/24/2021
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