Organization
M S SHEPARD PSYD LLC
Active
Other names
Michael S Shepard PsyD
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA MCGUIRE (CREDENTIALING/ BILLER)
(702) 776-7732
Entity
Organization
Contact information
Practice address
2775 S JONES BLVD, 101, LAS VEGAS, NV 89146-5631
(702) 326-5390
(702) 586-3333
Mailing address
2775 S JONES BLVD, 101, LAS VEGAS, NV 89146-5631
(702) 326-5390
(702) 586-3333
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY0540
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PY 0540
LICENSE
NV
Enumeration date
09/11/2012
Last updated
09/11/2012
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