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NPI Code Detail

MEDICARE: AYLA SHARP RESIDENT IN COUNSELI

MEDICARE: AYLA SHARP RESIDENT IN COUNSELI
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
1101YM0800XMental Health Counselor0704014611VA

General Provider Information

NPI Number : 1881348134
Entity Type Code : Individual
Provider Name (Legal Business Name) : AYLA SHARP RESIDENT IN COUNSELI
Provider Business Mailing Address
First Line : 2732 BRANDON AVE SW APT D1
Second Line :
City : ROANOKE
State : VA
Zip : 24015-3300
Country : US
Telephone Number : 540-246-8996
Fax Number :
Provider Business Practice Location Address
First Line : 2100 ROANOKE ST STE 100
Second Line :
City : CHRISTIANSBURG
State : VA
Zip : 24073-2512
Country : US
Telephone Number : 540-322-3040
Fax Number : 540-394-7105
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2022
Last Update Date : 02/07/2022

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Directions to “ AYLA SHARP RESIDENT IN COUNSELI” Practice Location

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