Shepherd, Tereasa Dianne
Shepherd, Tereasa Dianne is an sole proprietor health care provider with primary practice located at 595 N Courtenay Pkwy #203, Merritt Island FL 32953-4851. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Shepherd, Tereasa Dianne can be contacted via phone (321) 453-8484.Contact Information
Primary practice address
595 N Courtenay Pkwy #203
Merritt Island FL 32953-4851
Phone: (321) 453-8484
Fax: (321) 453-8448
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT11406 | Florida |
Profile Details
| NPI number | 1780789420 |
|---|---|
| LBN Legal business name | Shepherd, Tereasa Dianne |
| Credentials | P.T., MSHA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 14th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780789420 | NPPES |
| Florida | Other | Y904D | BCBS |
| Florida | Other | 043709119002 | BCBS |
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