| NPI | 1811417934 |
|---|---|
| Former Name | ANGELA RENEE SHEPHERD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: OK 311698) |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2024-02-22 |