Provider Demographics
NPI:1326289091
Name:SHARP, LAURA M (PSYCHOLOGIST)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:M
Last Name:SHARP
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 W LIBERTY ST
Mailing Address - Street 2:SUITE 113
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-2798
Mailing Address - Country:US
Mailing Address - Phone:717-509-5151
Mailing Address - Fax:717-509-6734
Practice Address - Street 1:313 W LIBERTY ST
Practice Address - Street 2:SUITE 113
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-2798
Practice Address - Country:US
Practice Address - Phone:717-509-5151
Practice Address - Fax:717-509-6734
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016513103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018952270006Medicaid