Provider Demographics
NPI:1689051781
Name:SHARP, MOLLY (MA)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:SHARP
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 HUDSON DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-5655
Mailing Address - Country:US
Mailing Address - Phone:561-706-9634
Mailing Address - Fax:
Practice Address - Street 1:256 HUDSON DR
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-5655
Practice Address - Country:US
Practice Address - Phone:561-706-9634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist