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NPI Code Detail

MEDICARE: SHARON ROSE-REGO, PH.D., LLC

MEDICARE: SHARON ROSE-REGO, PH.D., LLC
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
1103TC0700XClinical Psychologist5879OH

General Provider Information

NPI Number : 1972987774
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHARON ROSE-REGO, PH.D., LLC
Provider Business Mailing Address
First Line : 6151 WILSON MILLS RD
Second Line : SUITE 200
City : HIGHLAND HEIGHTS
State : OH
Zip : 44143-2153
Country : US
Telephone Number : 440-781-9609
Fax Number :
Provider Business Practice Location Address
First Line : 6151 WILSON MILLS RD
Second Line : SUITE 200
City : HIGHLAND HEIGHTS
State : OH
Zip : 44143-2153
Country : US
Telephone Number : 440-781-9609
Fax Number :
Authorized Official
Title or Position : OWNER/PSYCHOLOGIST
Name : DR. SHARON ROSE-REGO
Credential : PH.D.
Telephone Number : 440-781-9609
Provider Enumeration Date : 07/13/2015
Last Update Date : 07/13/2015

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