Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 8582 | NC |
NPI | 1043454036 |
---|---|
Provider Name | Miss Dana Lauren Shepherd |
First Address | Monroe, NC 28110-6349 |
Second Address | Monroe, NC 28110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2009 |
Last Update Date | 03/02/2015 |