Provider Demographics
NPI:1922607167
Name:ROBERTS, SHARITA (DODD)
Entity Type:Individual
Prefix:
First Name:SHARITA
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:DODD
Other - Prefix:
Other - First Name:SHARITA
Other - Middle Name:
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DODD
Mailing Address - Street 1:3867 INDEPENDENCE RD
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44105-3356
Mailing Address - Country:US
Mailing Address - Phone:216-333-9336
Mailing Address - Fax:
Practice Address - Street 1:3867 INDEPENDENCE RD
Practice Address - Street 2:
Practice Address - City:NEWBURGH HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44105-3356
Practice Address - Country:US
Practice Address - Phone:216-333-9336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No372500000XNursing Service Related ProvidersChore Provider