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General NPI Number Information
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NPI Number | 1962693648
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Entity Type | Individual
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Provider Name | LEIGH ANN MARIE SHEPHERD M.A., BCBA
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Gender | Female
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 09/21/2011
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Provider Practice Location Address
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Address Line | 20135 STATE ROUTE 245
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City | MARYSVILLE
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State | OH
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Zip | 43040-9114
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Country | US
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Telephone | 614-582-5634
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Fax | 937-642-4470
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Provider Business Mailing Address
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Address Line | PO BOX 915
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City | MARYSVILLE
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State | OH
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Zip | 43040-0915
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Country | US
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Telephone | 614-582-5634
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Fax | 937-642-4470
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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