MEDICARE: MELINDA SHEPPARD M.A. L.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	19239	TX

General Provider Information

NPI Number	:	1477522613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELINDA SHEPPARD M.A. L.P.C.

Provider Business Mailing Address
First Line	:	343 W HOUSTON ST STE 1010
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78205-2271
Country	:	US
Telephone Number	:	210-354-1186
Fax Number	:	210-354-1187

Provider Business Practice Location Address
First Line	:	343 W HOUSTON ST STE 1010
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78205-2271
Country	:	US
Telephone Number	:	210-354-1186
Fax Number	:	210-354-1187

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2006
Last Update Date	:	02/09/2009

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