Provider Demographics
NPI:1003122979
Name:JONES-FORRESTER, SHARON (PHD)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:JONES-FORRESTER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89101-6922
Mailing Address - Country:US
Mailing Address - Phone:725-605-8980
Mailing Address - Fax:702-382-3998
Practice Address - Street 1:716 S 6TH ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89101-6922
Practice Address - Country:US
Practice Address - Phone:702-510-6502
Practice Address - Fax:702-382-4993
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-29
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0604103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical