Provider Demographics
NPI:1962693648
Name:SHEPHERD, LEIGH ANN MARIE (MA, BCBA)
Entity type:Individual
Prefix:MRS
First Name:LEIGH ANN
Middle Name:MARIE
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
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Mailing Address - Street 1:PO BOX 915
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-0915
Mailing Address - Country:US
Mailing Address - Phone:614-582-5634
Mailing Address - Fax:937-642-4470
Practice Address - Street 1:20135 STATE ROUTE 245
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-9114
Practice Address - Country:US
Practice Address - Phone:614-582-5634
Practice Address - Fax:937-642-4470
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst