Provider Demographics
NPI:1336356435
Name:SHEPPARD, IRMA (MA LPC)
Entity Type:Individual
Prefix:MS
First Name:IRMA
Middle Name:
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:MS
Other - First Name:IRMHILD
Other - Middle Name:
Other - Last Name:SHEPPARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA LPC
Mailing Address - Street 1:7320 NORTH VILLAGE AVENUE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704
Mailing Address - Country:US
Mailing Address - Phone:520-321-0433
Mailing Address - Fax:520-321-0433
Practice Address - Street 1:7320 NORTH VILLAGE AVENUE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704
Practice Address - Country:US
Practice Address - Phone:520-321-0433
Practice Address - Fax:520-321-0433
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0957101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health