Healthcare Provider Details

I. General information

NPI: 1215864426
Provider Name (Legal Business Name): RACHAEL MARIE SHEPHERD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6770 AVERY MUIRFIELD DR
DUBLIN OH
43017-1241
US

IV. Provider business mailing address

3540 E MAIN ST UNIT 326
WHITEHALL OH
43213-3706
US

V. Phone/Fax

Practice location:
  • Phone: 614-697-3600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberCDCAPRE.195957
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: