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Individual

CHRISTINE E SHEPHERD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CMT, NCBTMB, LPC

Contact information

Practice address
37 N SCOTT ST STE 28, SHERIDAN, WY 82801-6361
(307) 752-1387
(307) 672-8508
Mailing address
611 MOUNTAIN SHADOWS BLVD, SHERIDAN, WY 82801-9356
(307) 752-1387
(307) 672-8508

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
NO LICENSING BOARD
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000 390286-00
NCBTMB
01
83778
AMTA
Enumeration date
06/18/2007
Last updated
07/08/2007
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