Provider Demographics
NPI:1922171552
Name:FRIED BUCHALTER, SHARON (PHD,CHT)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:FRIED BUCHALTER
Suffix:
Gender:F
Credentials:PHD,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5828 NW 26TH CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2228
Mailing Address - Country:US
Mailing Address - Phone:561-496-6622
Mailing Address - Fax:561-865-1720
Practice Address - Street 1:4800 LINTON BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-6584
Practice Address - Country:US
Practice Address - Phone:561-496-6622
Practice Address - Fax:561-865-1720
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY005081103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist