Healthcare Provider Details

I. General information

NPI: 1497673263
Provider Name (Legal Business Name): SHAREE THOMAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CREEKSIDE DR STE 511-515
POTTSTOWN PA
19464-9217
US

IV. Provider business mailing address

643 CHARLES DR
GILBERTSVILLE PA
19525-9661
US

V. Phone/Fax

Practice location:
  • Phone: 888-966-0746
  • Fax:
Mailing address:
  • Phone: 484-300-3131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH008570
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: