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1962872739
KEVIN SHEPHERD
URBANA, IL
NPI
1962872739
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: IL 149.017708)
Enumeration Date
2015-10-05
Last Update Date
2015-10-05
Business Address
Mr. KEVIN SHEPHERD LCSW
2012 E AMBER LN APARTMENT 206
URBANA, IL 61802-6971
Phone number: 217-474-2928
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Mailing Address
Mr. KEVIN SHEPHERD LCSW
2012 E AMBER LN APARTMENT 206
URBANA, IL 61802-6971
Phone number: 217-474-2928
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