Basic Information
| Provider Information | |||||||||
| NPI: | 1396038329 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHARPLES | ||||||||
| FirstName: | TAUSHA | ||||||||
| MiddleName: | |||||||||
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| Credential: | PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3130 GLENDALE AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436145811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193833815 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3130 GLENDALE AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436145801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193833815 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2011 | ||||||||
| LastUpdateDate: | 06/03/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | C.0700398 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.