Provider Demographics
NPI:1609617299
Name:SHARPE, EMILY ANN MARIE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN MARIE
Last Name:SHARPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3141 E 32ND AVE APT B
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4867
Mailing Address - Country:US
Mailing Address - Phone:360-510-0686
Mailing Address - Fax:
Practice Address - Street 1:3141 E 32ND AVE APT B
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-4867
Practice Address - Country:US
Practice Address - Phone:360-510-0686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACB61492009106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician