Provider Demographics
NPI:1356674428
Name:NOONEY, SHARON IBU (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:IBU
Last Name:NOONEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:IBU
Other - Last Name:SUGAWARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2323 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-3546
Mailing Address - Country:US
Mailing Address - Phone:712-255-6510
Mailing Address - Fax:
Practice Address - Street 1:3200 G ST
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-3339
Practice Address - Country:US
Practice Address - Phone:402-494-3043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1381225X00000X
IA495225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist