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1205046406
GERALD SHEPHARD
PORT JEFFERSON STATION, NY
NPI
1205046406
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY L015893)
Enumeration Date
2007-05-23
Last Update Date
2007-07-08
Business Address
Mr. GERALD SHEPHARD LCSW
164 HOWARD ST
PORT JEFFERSON STATION, NY 11776-2520
Phone number: 631-828-1230
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Mailing Address
Mr. GERALD SHEPHARD LCSW
164 HOWARD ST
PORT JEFFERSON STATION, NY 11776-2520
Phone number: 631-828-1230
Copy
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