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General NPI Number Information
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NPI Number | 1871886150
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Entity Type | Organization
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Legal Business Name | VICTORIA SHARP, PA
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Dates
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Enumeration Date | 05/19/2011
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Last Update Date | 05/19/2011
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Provider Practice Location Address
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Address Line | 1940 10TH AVE SUITE B
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City | VERO BEACH
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State | FL
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Zip | 32960-6458
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Country | US
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Telephone | 772-633-7127
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2186
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City | VERO BEACH
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State | FL
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Zip | 32961-2186
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Country | US
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Telephone | 772-633-7127
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VICTORIA SHARP
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Credential | LMHC
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Telephone | 772-633-7127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 8073
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License Number State | FL
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