Doctor Name: | MS. PENELOPE (PENNY) DAWN SHEPHERD |
NPI Number: | 1366791659 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPCC/S |
License Number: | E.09000015 SUPV |
Business Practice Address: | 402 W Main St Barnesville, OH - 437131034 |
Business Phone Number: | 7402130381 |
Business Fax Number: | |
Mailing Address: | 402 W Main St, BARNESVILLE |
State: | OH |
Postal Code: | 437131034 |
Phone Number: | 7402130381 |
Fax Number: | |
NPI Enumeration Date: | 09/03/2012 |
NPI Last Update Date: | 09/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | E.09000015 SUPV |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |