MEDICARE: ABIGAIL SHEPARD

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	106S00000X	Behavior Technician		TN

General Provider Information

NPI Number	:	1790618734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL SHEPARD

Provider Business Mailing Address
First Line	:	300 INTERNATIONAL PKWY STE 200
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32746-5028
Country	:	US
Telephone Number	:	866-610-0580
Fax Number	:	866-611-1558

Provider Business Practice Location Address
First Line	:	3326 ASPEN GROVE DR UNIT 604
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-2837
Country	:	US
Telephone Number	:	629-236-4547
Fax Number	:

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

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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Directions to “ ABIGAIL SHEPARD ” Practice Location

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