Provider Demographics
NPI:1881348134
Name:SHARP, AYLA (RESIDENT IN COUNSELI)
Entity type:Individual
Prefix:
First Name:AYLA
Middle Name:
Last Name:SHARP
Suffix:
Gender:F
Credentials:RESIDENT IN COUNSELI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2732 BRANDON AVE SW APT D1
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-3300
Mailing Address - Country:US
Mailing Address - Phone:540-246-8996
Mailing Address - Fax:
Practice Address - Street 1:2100 ROANOKE ST STE 100
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-2512
Practice Address - Country:US
Practice Address - Phone:540-322-3040
Practice Address - Fax:540-394-7105
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704014611101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health