Individual
JODY SHEPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1251 N ARDENWOOD DR APT 26, BATON ROUGE, LA 70806-1935
(504) 799-5085
Mailing address
1251 N ARDENWOOD DR APT 26, BATON ROUGE, LA 70806-1935
(504) 799-5085
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000
—
LA
Enumeration date
09/12/2017
Last updated
07/21/2022
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