Provider Demographics
NPI:1669641544
Name:SAVARESE, SHARON JEAN (MA CCC SP)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:JEAN
Last Name:SAVARESE
Suffix:
Gender:F
Credentials:MA CCC SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08260
Mailing Address - Country:US
Mailing Address - Phone:609-729-6622
Mailing Address - Fax:609-729-6622
Practice Address - Street 1:3004 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08260-2529
Practice Address - Country:US
Practice Address - Phone:609-729-6622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00157600235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2431207060OtherAMERIHEALTH