Provider Demographics
NPI:1841749082
Name:LEE, SHARON EDWARDS
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:EDWARDS
Last Name:LEE
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 1:10 CORA LN
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70706-3206
Mailing Address - Country:US
Mailing Address - Phone:225-572-9304
Mailing Address - Fax:
Practice Address - Street 1:10 CORA LN
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70706-3206
Practice Address - Country:US
Practice Address - Phone:225-572-9304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health