Provider Demographics
NPI:1568747996
Name:TAYLOR, SHARON H
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:H
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SHARON
Other - Middle Name:H
Other - Last Name:RISSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6020 CRYSTAL CASCADE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-1500
Mailing Address - Country:US
Mailing Address - Phone:702-395-9933
Mailing Address - Fax:
Practice Address - Street 1:3550 W CHEYENNE AVE STE 130
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-8252
Practice Address - Country:US
Practice Address - Phone:702-648-3913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health