Provider Demographics
NPI:1922618149
Name:SIPE, SHARANDA
Entity Type:Individual
Prefix:
First Name:SHARANDA
Middle Name:
Last Name:SIPE
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 1:4941 HAVERHILL COMMONS CIR APT 27
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-5980
Mailing Address - Country:US
Mailing Address - Phone:561-667-2232
Mailing Address - Fax:
Practice Address - Street 1:4941 HAVERHILL COMMONS CIR APT 27
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-5980
Practice Address - Country:US
Practice Address - Phone:561-667-2232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-03
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator