Healthcare Provider Details

I. General information

NPI: 1962858407
Provider Name (Legal Business Name): SHARON BARRETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2016
Last Update Date: 05/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 HYDE HILL ROAD
GOSHEN MA
01032
US

IV. Provider business mailing address

PO BOX 505
WILLIAMSBURG MA
01096-0505
US

V. Phone/Fax

Practice location:
  • Phone: 413-207-1092
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: