Provider Demographics
NPI:1467505461
Name:AUSTIN, SHARON PATRICIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:PATRICIA
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 CANYON AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-2677
Mailing Address - Country:US
Mailing Address - Phone:970-493-4093
Mailing Address - Fax:
Practice Address - Street 1:315 CANYON AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2677
Practice Address - Country:US
Practice Address - Phone:970-493-4093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2113103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical