Provider Demographics
NPI:1083818272
Name:FISHER, SHARON ANN (OTR)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ANN
Last Name:FISHER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12763 DOMINGO CT
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-6644
Mailing Address - Country:US
Mailing Address - Phone:404-966-3314
Mailing Address - Fax:303-433-1574
Practice Address - Street 1:1027 TURNBERRY CIR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9594
Practice Address - Country:US
Practice Address - Phone:303-870-9302
Practice Address - Fax:303-433-1574
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002368225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000916374AMedicaid