Provider Demographics
NPI:1437784303
Name:SHEPARD, JENNIFER ASHLEY (PSYD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ASHLEY
Last Name:SHEPARD
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 1:8622 WINTON RD STE A
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-4823
Mailing Address - Country:US
Mailing Address - Phone:513-275-6023
Mailing Address - Fax:
Practice Address - Street 1:8622 WINTON RD STE A
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-4823
Practice Address - Country:US
Practice Address - Phone:860-967-4070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.07965103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical