Individual
MS. HOLLY SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC, ICS
Contact information
Practice address
23 W SCOTT ST., FOND DU LAC, WI 54935
(920) 926-0101
(920) 926-0060
Mailing address
23 W SCOTT ST., FOND DU LAC, WI 54935
(920) 926-0101
(920) 926-0060
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15462132
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100012753
—
WI
Enumeration date
11/29/2010
Last updated
05/03/2016
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