Individual
MRS. BEVERLY VIRGINA SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
5250 NORTH LAND DR, SUITE A, GRAND RAPIDS, MI 49525
(616) 361-5001
(616) 361-2166
Mailing address
5250 NORTH LAND DR, SUITE A, GRAND RAPIDS, MI 49525
(616) 361-5001
(616) 361-2166
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301012618
MI
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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