Provider Demographics
NPI:1114185782
Name:SHARON, DANIELLE N (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:N
Last Name:SHARON
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 1:1028 CHAPIN AVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-4723
Mailing Address - Country:US
Mailing Address - Phone:248-212-9429
Mailing Address - Fax:
Practice Address - Street 1:6020 W MAPLE RD
Practice Address - Street 2:SUITE 501
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4409
Practice Address - Country:US
Practice Address - Phone:248-212-9429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18410103T00000X
MI6301013806103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist