Individual
NICOLE SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18W261 KNOLLWOOD LN, VILLA PARK, IL 60181-3636
(630) 487-7405
Mailing address
18W261 KNOLLWOOD LN, VILLA PARK, IL 60181-3636
(630) 487-7405
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
02/14/2024
Last updated
02/14/2024
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