Individual
BETHANI ANN SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 S. WILLOW ST., #9, KENAI, AK 99611
(907) 283-0085
(907) 283-0084
Mailing address
130 S. WILLOW ST. #9, #9, KENAI, AK 99611
(907) 283-0085
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
175T00000X
Peer Specialist
—
AK
373H00000X
Day Training/Habilitation Specialist
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
05/25/2022
Last updated
04/08/2024
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