Individual
JENNA H SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
7900 W JEFFERSON BLVD, SUITE 304, FORT WAYNE, IN 46804-4128
(260) 435-6200
(260) 435-6201
Mailing address
7900 W JEFFERSON BLVD, SUITE 304, FORT WAYNE, IN 46804-4128
(260) 435-6200
(260) 435-6201
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
IN PROCESS
IN
Other
Enumeration date
01/28/2009
Last updated
03/25/2010
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