MEDICARE: SHARON SHAVER IMFT

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	106H00000X	Marriage & Family Therapist	F.2100181	OH

General Provider Information

NPI Number	:	1851820708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON SHAVER IMFT

Provider Business Mailing Address
First Line	:	435 CORONA AVE
Second Line	:
City	:	OAKWOOD
State	:	OH
Zip	:	45419-2606
Country	:	US
Telephone Number	:	209-620-2986
Fax Number	:

Provider Business Practice Location Address
First Line	:	5335 FAR HILLS AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45429-2350
Country	:	US
Telephone Number	:	937-660-5577
Fax Number	:

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

Provider Enumeration Date	:	06/05/2017
Last Update Date	:	05/03/2023

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Directions to “ SHARON SHAVER IMFT” Practice Location

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