Provider Demographics
NPI:1043535891
Name:SHARMA, DEEPIKA (MS)
Entity type:Individual
Prefix:
First Name:DEEPIKA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 BRAYFORD WAY
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-5360
Mailing Address - Country:US
Mailing Address - Phone:803-466-7554
Mailing Address - Fax:
Practice Address - Street 1:730 PEACHTREE ST NE STE 570
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-1244
Practice Address - Country:US
Practice Address - Phone:803-466-7554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054818263103K00000X
GA1-10-7455103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst