Individual
CARLEY J SHEPPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
464073 STATE ROAD 200, YULEE, FL 32097-6307
(800) 356-4049
(941) 485-0519
Mailing address
PO BOX 631278, OH, CINCINNATI, OH 45263-0001
(800) 356-4049
(941) 485-0519
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-45847
FL
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
RBT-18-65699
NJ
Other
Enumeration date
09/19/2018
Last updated
05/02/2023
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