Provider Demographics
NPI:1508662388
Name:SHEPARD, GRACE
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:SHEPARD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BEAVER BROOK CIR
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NH
Mailing Address - Zip Code:03031-2514
Mailing Address - Country:US
Mailing Address - Phone:703-232-0848
Mailing Address - Fax:
Practice Address - Street 1:7 BEAVER BROOK CIR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2514
Practice Address - Country:US
Practice Address - Phone:703-232-0848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach