Provider Demographics
NPI:1801003876
Name:SHARPE, LAURA KAY (BSE)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:KAY
Last Name:SHARPE
Suffix:
Gender:F
Credentials:BSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2124 LABETTE MANOR DR APT R24
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7333
Mailing Address - Country:US
Mailing Address - Phone:501-626-4011
Mailing Address - Fax:
Practice Address - Street 1:333 EXECUTIVE CT
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-4550
Practice Address - Country:US
Practice Address - Phone:501-526-8770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X, 251C00000X
AR222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No251C00000XAgenciesDay Training, Developmentally Disabled Services