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NPI Code Detail

MEDICARE: SHARON SOH LCSW

MEDICARE: SHARON SOH LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker60568TX

General Provider Information

NPI Number : 1619514395
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARON SOH LCSW
Provider Business Mailing Address
First Line : 3712 WICHITA ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76119-2866
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3712 WICHITA ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76119-2866
Country : US
Telephone Number : 682-432-1147
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2019
Last Update Date : 12/02/2019

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Directions to “ SHARON SOH LCSW” Practice Location

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