MEDICARE: MS. SHARON R BRILES MA

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	101YP2500X	Professional Counselor	37PC00386700	NJ

General Provider Information

NPI Number	:	1639341183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHARON R BRILES MA

Provider Business Mailing Address
First Line	:	2 SPLIT ROCK DR STE 6
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08003-1244
Country	:	US
Telephone Number	:	856-489-8155
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 SPLIT ROCK DR STE 6
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08003-1244
Country	:	US
Telephone Number	:	856-489-8155
Fax Number	:

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

Provider Enumeration Date	:	03/25/2008
Last Update Date	:	03/17/2009

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