Individual
KELLEE D SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1800 W 30TH ST, JOPLIN, MO 64804-1520
(417) 347-7580
Mailing address
PO BOX 2526, JOPLIN, MO 64803-2526
(417) 347-7579
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
2018020044
MO
1041C0700X
Clinical Social Worker
2018020044
MO
1041C0700X
Clinical Social Worker
Primary
2021001168
MO
Other
Enumeration date
08/08/2018
Last updated
01/19/2021
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