Provider Demographics
NPI:1952598146
Name:MCRAE, SHARON GLENDA (BIS, MSA)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:GLENDA
Last Name:MCRAE
Suffix:
Gender:F
Credentials:BIS, MSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22900 REMICK DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-2732
Mailing Address - Country:US
Mailing Address - Phone:586-783-4802
Mailing Address - Fax:586-783-4805
Practice Address - Street 1:22900 REMICK DR
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036-2732
Practice Address - Country:US
Practice Address - Phone:586-783-4802
Practice Address - Fax:586-783-4805
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)