Provider Demographics
NPI:1235978941
Name:SHEPARD, LINDA G
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:G
Last Name:SHEPARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 OLD HOMESTEAD HWY
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:NH
Mailing Address - Zip Code:03470-5012
Mailing Address - Country:US
Mailing Address - Phone:603-313-5137
Mailing Address - Fax:
Practice Address - Street 1:656 OLD HOMESTEAD HWY
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:NH
Practice Address - Zip Code:03470-5012
Practice Address - Country:US
Practice Address - Phone:603-313-5137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3617225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist