Provider Demographics
NPI:1891043972
Name:AUSTIN-HEAD, SHARON LEE
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LEE
Last Name:AUSTIN-HEAD
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 1:17420 TALFORD AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44128-1644
Mailing Address - Country:US
Mailing Address - Phone:216-751-0413
Mailing Address - Fax:
Practice Address - Street 1:17420 TALFORD AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-1644
Practice Address - Country:US
Practice Address - Phone:216-751-0413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor