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General NPI Number Information
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NPI Number | 1124339718
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Entity Type | Individual
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Provider Name | SHARON ESDALE LIC. AC.
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Gender | Female
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Dates
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Enumeration Date | 06/29/2010
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Last Update Date | 06/28/2011
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Provider Practice Location Address
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Address Line | 39 MAIN ST 3RD FLOOR
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City | NORTHAMPTON
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State | MA
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Zip | 01060-3578
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Country | US
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Telephone | 413-341-7151
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Fax |
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Provider Business Mailing Address
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Address Line | 315 SOUTHAMPTON RD
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City | WESTHAMPTON
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State | MA
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Zip | 01027-9538
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Country | US
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Telephone | 413-341-7151
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 0910047356
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 245948
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License Number State | MA
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