Individual
MS. DIANE A. SHEPPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LSW, MAC
Contact information
Practice address
166 MAIN ST., MATAWAN, NJ 07747
(732) 290-9040
(732) 566-0433
Mailing address
20 IMBROOK LANE, ABERDEEN, NJ 07747-1508
(732) 583-5447
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
44SL00879000
NJ
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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