=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043273584
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHARON A. FAUST OT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/07/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1401 BENJAMIN PKWY
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27408-4518
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-545-5000
-----------------------------------------------------
Fax | 336-545-3566
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 38008
-----------------------------------------------------
City | GREENSBORO
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27438-8008
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 336-545-5000
-----------------------------------------------------
Fax | 336-545-3566
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 0345
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------