Provider Demographics
NPI:1508573007
Name:SHEPPARD, FELICIA ROSE (RBT)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:ROSE
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 COMMERCIAL BLVD N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-7119
Mailing Address - Country:US
Mailing Address - Phone:682-521-5986
Mailing Address - Fax:
Practice Address - Street 1:1012 COMMERCIAL BLVD N
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-7119
Practice Address - Country:US
Practice Address - Phone:682-521-5986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician