Basic Information
| Provider Information | |||||||||
| NPI: | 1558370452 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARRISON | ||||||||
| FirstName: | SHARRON | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MA.LLP,LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 307 N VAN BUREN ST | ||||||||
| Address2: | |||||||||
| City: | BAY CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 487086520 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9899224243 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1102 MACKIN RD | ||||||||
| Address2: | |||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485031204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102573676 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2006 | ||||||||
| LastUpdateDate: | 09/29/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 680117980 | MI | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.