Provider Demographics
NPI:1184054181
Name:KEIGLER, SHARON
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:KEIGLER
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 1:167 STARKSVILLE AVE S
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-4551
Mailing Address - Country:US
Mailing Address - Phone:229-733-3756
Mailing Address - Fax:
Practice Address - Street 1:198 S MACARTHUR DR
Practice Address - Street 2:
Practice Address - City:CAMILLA
Practice Address - State:GA
Practice Address - Zip Code:31730-6370
Practice Address - Country:US
Practice Address - Phone:678-898-2306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health