Provider Demographics
NPI:1285670505
Name:SHARPSTEEN, M DALE (LMFT MED)
Entity Type:Individual
Prefix:MRS
First Name:M
Middle Name:DALE
Last Name:SHARPSTEEN
Suffix:
Gender:F
Credentials:LMFT MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 ROTHSVILLE RD
Mailing Address - Street 2:ROSEVILLE MEDICAL
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-8215
Mailing Address - Country:US
Mailing Address - Phone:717-627-5133
Mailing Address - Fax:717-627-5144
Practice Address - Street 1:2320 ROTHSVILLE RD
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543
Practice Address - Country:US
Practice Address - Phone:717-627-5133
Practice Address - Fax:717-627-5144
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000208106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist