| NPI | 1639566219 |
|---|---|
| Former Name | MELISSA SHEPARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 2019-01063) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MD 6983) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2019-09-16 |