Provider Demographics
NPI:1295374759
Name:SHARKEY, BLAIRE MARIE
Entity Type:Individual
Prefix:
First Name:BLAIRE
Middle Name:MARIE
Last Name:SHARKEY
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 1:212 ANDORRA GLEN CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-2522
Mailing Address - Country:US
Mailing Address - Phone:610-517-0565
Mailing Address - Fax:
Practice Address - Street 1:212 ANDORRA GLEN CT
Practice Address - Street 2:
Practice Address - City:LAFAYETTE HILL
Practice Address - State:PA
Practice Address - Zip Code:19444-2522
Practice Address - Country:US
Practice Address - Phone:610-517-0565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist