Provider Demographics
NPI:1740309574
Name:REED, SHARON (FP)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:FP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 E BRENTRUP DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-4926
Mailing Address - Country:US
Mailing Address - Phone:480-456-3079
Mailing Address - Fax:
Practice Address - Street 1:1959 E BRENTRUP DR
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-4926
Practice Address - Country:US
Practice Address - Phone:480-456-3079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ188186Medicaid