Provider Demographics
NPI:1801222484
Name:HAREWOOD, SHARICE (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:SHARICE
Middle Name:
Last Name:HAREWOOD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:SHARICE
Other - Middle Name:
Other - Last Name:HAREWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOT
Mailing Address - Street 1:1139 E 102ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-4439
Mailing Address - Country:US
Mailing Address - Phone:646-756-9574
Mailing Address - Fax:
Practice Address - Street 1:1139 E 102ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-4439
Practice Address - Country:US
Practice Address - Phone:646-756-9574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018103225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist