ETHAN ALVA SHEPPARD

SAN LUIS OBISPO, CA
NPI1063370799
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2026-01-12
Last Update Date2026-01-12
Business Address
ETHAN ALVA SHEPPARD
2180 JOHNSON AVE
SAN LUIS OBISPO, CA 93401-4558
Phone number: 805-781-4768
Mailing Address
ETHAN ALVA SHEPPARD
2180 JOHNSON AVE
SAN LUIS OBISPO, CA 93401-4558
Phone number:
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