Individual
LEAH R SHEPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2548 E KENOSHA ST, BROKEN ARROW, OK 74014-6712
(918) 355-0995
Mailing address
2548 E KENOSHA ST, BROKEN ARROW, OK 74014-6712
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/18/2023
Last updated
08/27/2023
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