Provider Demographics
NPI:1780435107
Name:REID, SHARON (DD, CHC)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:REID
Suffix:
Gender:F
Credentials:DD, CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4153C FLAT SHOALS PKWY STE 324E
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-4863
Mailing Address - Country:US
Mailing Address - Phone:470-314-0722
Mailing Address - Fax:
Practice Address - Street 1:4153C FLAT SHOALS PKWY STE 324E
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-4863
Practice Address - Country:US
Practice Address - Phone:470-314-0722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1925227800000X, 171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified