Provider Demographics
NPI:1255869442
Name:KONTRATH, SHARI ELIZABETH (BOCPD, CPED)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:ELIZABETH
Last Name:KONTRATH
Suffix:
Gender:F
Credentials:BOCPD, CPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6780 SAMBA ST
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34945-3069
Mailing Address - Country:US
Mailing Address - Phone:772-801-9475
Mailing Address - Fax:888-789-0771
Practice Address - Street 1:6780 SAMBA ST
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34945-3069
Practice Address - Country:US
Practice Address - Phone:772-801-9475
Practice Address - Fax:888-789-0771
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLC50548224L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224L00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPedorthist