Provider Demographics
NPI:1174040505
Name:RAY, SHARON (MASTER COSMETOLOGY)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:MASTER COSMETOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12303 PARKTON ST
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-6135
Mailing Address - Country:US
Mailing Address - Phone:202-437-7562
Mailing Address - Fax:
Practice Address - Street 1:12303 PARKTON ST
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744
Practice Address - Country:US
Practice Address - Phone:202-437-7562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD368671744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty