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1003563958
CODY ALLEN SHEPHERD
VISTA, CA
NPI
1003563958
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2022-03-09
Last Update Date
2022-03-09
Business Address
CODY ALLEN SHEPHERD
993 POSTAL WAY
VISTA, CA 92083-6945
Phone number: 760-630-9922
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Mailing Address
CODY ALLEN SHEPHERD
993 POSTAL WAY
VISTA, CA 92083-6945
Phone number: 760-630-9922
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