Provider Demographics
NPI:1467560193
Name:BARKDOLL, SHARON GRACE (PT)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:GRACE
Last Name:BARKDOLL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 BABET WAY
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2064
Mailing Address - Country:US
Mailing Address - Phone:410-850-5755
Mailing Address - Fax:
Practice Address - Street 1:3570 SAINT JOHNS LN
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-4020
Practice Address - Country:US
Practice Address - Phone:410-461-6776
Practice Address - Fax:410-461-3206
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD17593OtherLICENSE #