Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1073828752 |
---|---|
Provider Name | Caitlin Briana Shepherd |
First Address | Amherst, MA 01002-2362 |
Second Address | Amherst, MA 01002-2362 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2010 |
Last Update Date | 10/06/2015 |