Provider Demographics
NPI:1578723235
Name:CALCUTT, SHARON ANN
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ANN
Last Name:CALCUTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825B RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLY HILL
Mailing Address - State:FL
Mailing Address - Zip Code:32117-1737
Mailing Address - Country:US
Mailing Address - Phone:386-671-2626
Mailing Address - Fax:386-671-2627
Practice Address - Street 1:1825B RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:HOLLY HILL
Practice Address - State:FL
Practice Address - Zip Code:32117-1737
Practice Address - Country:US
Practice Address - Phone:386-671-2626
Practice Address - Fax:386-671-2627
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9884225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1023113503OtherNPI NUMBER