Individual
JASON DALE SHEPHERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
525 LIBERTY LN, EDMOND, OK 73034-9046
(405) 726-8966
Mailing address
3416 NW 19TH ST, OKLAHOMA CITY, OK 73107-3830
(405) 417-1457
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Enumeration date
10/30/2025
Last updated
10/30/2025
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