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General NPI Number Information
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NPI Number | 1225686892
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Entity Type | Individual
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Provider Name | SHARON LASHAY BROOKS
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Gender | Female
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 06/02/2023
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Provider Practice Location Address
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Address Line | 8218 ARBOR MEADOW WAY
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City | LOUISVILLE
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State | KY
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Zip | 40228-4414
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Country | US
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Telephone | 502-921-7133
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Fax |
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Provider Business Mailing Address
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Address Line | 8218 ARBOR MEADOW WAY
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City | LOUISVILLE
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State | KY
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Zip | 40228-4414
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Country | US
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Telephone |
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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 | 103TM1800X
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Taxonomy Name | Intellectual & Developmental Disabilities Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-19-76750
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 285355
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License Number State | KY
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