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Individual

MRS. REGAN A SHEPPARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMFT

Contact information

Practice address
810 E JACKSON ST, SUITE 200, MEDFORD, OR 97504-6773
(360) 224-0110
Mailing address
810 E JACKSON ST, SUITE 200, MEDFORD, OR 97504-6773
(541) 526-1953

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
T0776
OR
106H00000X
Marriage & Family Therapist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RC00053311
REGISTERED COUNSELOR
WA
Enumeration date
02/20/2007
Last updated
05/05/2015
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