Provider Demographics
NPI:1407157696
Name:FLAMINIO, SHARON (OTR)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:FLAMINIO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5520 GLOSTER DR APT 2C
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-6099
Mailing Address - Country:US
Mailing Address - Phone:716-807-7922
Mailing Address - Fax:
Practice Address - Street 1:5520 GLOSTER DR APT 2C
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24019-6099
Practice Address - Country:US
Practice Address - Phone:716-807-7922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3304225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist