Provider Demographics
NPI:1295910222
Name:SHARON R HOBBS, PC
Entity type:Organization
Organization Name:SHARON R HOBBS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FULLY LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:R
Authorized Official - Last Name:HOBBS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:517-351-2590
Mailing Address - Street 1:200 WOODLAND PASS STE G
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-2000
Mailing Address - Country:US
Mailing Address - Phone:517-351-2590
Mailing Address - Fax:517-351-2733
Practice Address - Street 1:200 WOODLAND PASS STE G
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-2000
Practice Address - Country:US
Practice Address - Phone:517-351-2590
Practice Address - Fax:517-351-2733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISH006000103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOP38440Medicare PIN