Provider Demographics
NPI:1598996860
Name:KRIDLE, SHARON LEE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LEE
Last Name:KRIDLE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 S RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36867-6220
Mailing Address - Country:US
Mailing Address - Phone:334-291-6363
Mailing Address - Fax:334-291-6399
Practice Address - Street 1:1011 S RAILROAD ST
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-6220
Practice Address - Country:US
Practice Address - Phone:334-291-6363
Practice Address - Fax:334-291-6399
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical