Provider Demographics
NPI:1982184735
Name:SHARP, HARLIE MARIAH
Entity Type:Individual
Prefix:MRS
First Name:HARLIE
Middle Name:MARIAH
Last Name:SHARP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HARLIE
Other - Middle Name:MARIAH
Other - Last Name:HARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 S 320TH ST APT C6
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-4602
Mailing Address - Country:US
Mailing Address - Phone:509-398-7178
Mailing Address - Fax:
Practice Address - Street 1:333 S 320TH ST APT C6
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-4602
Practice Address - Country:US
Practice Address - Phone:509-398-7178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACB60900716106S00000X
WABA61221561103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2111479Medicaid