Provider Demographics
NPI:1336365683
Name:SHEPHERD, JANET S (PHD)
Entity type:Individual
Prefix:DR
First Name:JANET
Middle Name:S
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 SAINT ANNE DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-5635
Mailing Address - Country:US
Mailing Address - Phone:319-354-4621
Mailing Address - Fax:
Practice Address - Street 1:221 E COLLEGE ST
Practice Address - Street 2:SUITE 211
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-1699
Practice Address - Country:US
Practice Address - Phone:319-337-3313
Practice Address - Fax:319-656-4223
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA639103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical