Individual
DR. STEPHEN SHEPPARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
30 N 1900 E, 1R52 SOM, SALT LAKE CITY, UT 84132-2119
(801) 581-6228
(801) 585-6702
Mailing address
2840 CANYON VIEW DR, SALT LAKE CITY, UT 84109-2005
(801) 581-6228
(801) 585-6702
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
353104-2501
UT
103TA0400X
Addiction (Substance Use Disorder) Psychologist
353104-2501
UT
Other
Enumeration date
02/09/2007
Last updated
07/30/2014
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