Provider Demographics
NPI:1952554040
Name:SHEPHERD, AARON MICHAEL (MA, PSYS)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:MICHAEL
Last Name:SHEPHERD
Suffix:
Gender:M
Credentials:MA, PSYS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38345 W 10 MILE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48335-2883
Mailing Address - Country:US
Mailing Address - Phone:734-756-1214
Mailing Address - Fax:
Practice Address - Street 1:38345 WEST 10 MILE ROAD SUITE 150
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48335
Practice Address - Country:US
Practice Address - Phone:734-756-1214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012538103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical