Doctor Name: | HEATHER MARIE SHEPHERD |
NPI Number: | 1194057679 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CMT |
License Number: | |
Business Practice Address: | 328 Heritage Pl Ste A Faribault, MN - 550215251 |
Business Phone Number: | 5073320202 |
Business Fax Number: | |
Mailing Address: | 316 Rose Dr, FARIBAULT |
State: | MN |
Postal Code: | 550211819 |
Phone Number: | 5073301347 |
Fax Number: | |
NPI Enumeration Date: | 02/08/2010 |
NPI Last Update Date: | 02/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |