Provider Demographics
NPI:1851927750
Name:HARLEY, SHARIKA D (HAIR LOSS SPT)
Entity Type:Individual
Prefix:
First Name:SHARIKA
Middle Name:D
Last Name:HARLEY
Suffix:
Gender:F
Credentials:HAIR LOSS SPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1572 SAM RITTENBERG BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-4105
Mailing Address - Country:US
Mailing Address - Phone:843-367-3155
Mailing Address - Fax:
Practice Address - Street 1:1572 SAM RITTENBERG BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-4105
Practice Address - Country:US
Practice Address - Phone:843-367-3155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC675161744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management