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Individual

MR. GARY SHEPHERD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
214 BUSH RIVER DR, FARMVILLE, VA 23901-3179
(434) 392-3187
(434) 392-5789
Mailing address
214 BUSH RIVER DR, FARMVILLE, VA 23901-3179
(434) 392-3187
(434) 392-5789

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0701005670
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
540988560
COMMERCIAL
VA
Enumeration date
12/16/2013
Last updated
12/16/2013
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