Provider Demographics
NPI:1003351180
Name:SHARPE, THERESA MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:MARIE
Last Name:SHARPE
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 1:5337 YORKTOWN BLVD
Mailing Address - Street 2:SUITE A41
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-5376
Mailing Address - Country:US
Mailing Address - Phone:361-271-1781
Mailing Address - Fax:
Practice Address - Street 1:5337 YORKTOWN BLVD
Practice Address - Street 2:SUITE A41
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78413-5376
Practice Address - Country:US
Practice Address - Phone:361-271-1781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32023103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist