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Individual

MRS. LORI DIANE SHEPARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2504 CAMINO ENTRADA, SANTA FE, NM 87507-4851
(505) 471-5006
Mailing address
4752 LLUVIA ENCANTADA, SANTA FE, NM 87507-0857
(832) 573-3932

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-10276
NM

Other

Enumeration date
08/28/2019
Last updated
08/28/2019
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