Provider Demographics
NPI:1043869852
Name:CRITTENDEN, SHARRON LEIGH (DACM, LAC)
Entity type:Individual
Prefix:
First Name:SHARRON
Middle Name:LEIGH
Last Name:CRITTENDEN
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:SHARRON
Other - Middle Name:LEIGH
Other - Last Name:LIPSCOMB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:410 VILLA RICA WAY SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-5741
Mailing Address - Country:US
Mailing Address - Phone:678-761-3677
Mailing Address - Fax:
Practice Address - Street 1:410 VILLA RICA WAY SW
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-5741
Practice Address - Country:US
Practice Address - Phone:678-761-3677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA438171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist