MEDICARE: MRS. SHARON KAY ALLEN LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801059472	MI

General Provider Information

NPI Number	:	1013133792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHARON KAY ALLEN LMSW

Provider Business Mailing Address
First Line	:	1817 W STADIUM BLVD STE C
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-4577
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2365 S HURON PKWY
Second Line	:	SUITE A
City	:	ANN ARBOR
State	:	MI
Zip	:	48104-5156
Country	:	US
Telephone Number	:	734-913-9548
Fax Number	:	734-973-7508

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	11/14/2019

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