Provider Demographics
NPI:1740587146
Name:SHEPHERD, LYNNE ANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:ANNE
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3418 MERCER ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-6527
Mailing Address - Country:US
Mailing Address - Phone:713-303-2173
Mailing Address - Fax:
Practice Address - Street 1:9406 BOB WHITE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-3708
Practice Address - Country:US
Practice Address - Phone:713-303-2173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33022103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical