Individual
MRS. MAE ANN SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LADC
Contact information
Practice address
5569 S LEWIS AVE, TULSA, OK 74105-7132
(918) 845-6885
Mailing address
8952 S DARLINGTON AVE, TULSA, OK 74137-3559
(918) 845-6885
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
306
OK
101YP2500X
Professional Counselor
Primary
2641
OK
Other
Enumeration date
06/11/2007
Last updated
05/16/2011
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