MEDICARE: SHARON CAMILLA JOSEPH

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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1720408792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON CAMILLA JOSEPH

Provider Business Mailing Address
First Line	:	9019 S DELAWARE AVE UNIT 502
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-3359
Country	:	US
Telephone Number	:	571-296-5234
Fax Number	:

Provider Business Practice Location Address
First Line	:	9019 S DELAWARE AVE UNIT 502
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74137-3359
Country	:	US
Telephone Number	:	571-296-5234
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2014
Last Update Date	:	04/17/2014

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