| Doctor Name: | MRS. KIMBERLY LYNN SHEPPARD |
| NPI Number: | 1215052881 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | LPC005385 |
| Business Practice Address: | 1456 Battlefield Pkwy Suite 5e Fort Oglethorpe, GA - 307424012 |
| Business Phone Number: | 4233132060 |
| Business Fax Number: | 4236296967 |
| Mailing Address: | 1407 N Moore Rd, CHATTANOOGA |
| State: | TN |
| Postal Code: | 374111218 |
| Phone Number: | 4233132060 |
| Fax Number: | 4236296967 |
| NPI Enumeration Date: | 03/20/2007 |
| NPI Last Update Date: | 12/28/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC005385 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |