Individual
TRACY SHEPHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15101 SHELL POINT BLVD, FORT MYERS, FL 33908-1694
(239) 466-1131
Mailing address
9648 HEMINGWAY LN APT 4405, FORT MYERS, FL 33913-7082
(440) 225-6212
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA17676
FL
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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