Provider Demographics
NPI:1114487253
Name:NORTHINGTON, SHARIE
Entity Type:Individual
Prefix:
First Name:SHARIE
Middle Name:
Last Name:NORTHINGTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8816 NE 45TH ST
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:OK
Mailing Address - Zip Code:73084-2576
Mailing Address - Country:US
Mailing Address - Phone:405-812-8005
Mailing Address - Fax:405-231-3157
Practice Address - Street 1:4001 N CLASSEN BLVD STE 225
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-2670
Practice Address - Country:US
Practice Address - Phone:405-231-3150
Practice Address - Fax:405-231-3157
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-24
Last Update Date:2019-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor