Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 2013-07 | KY |
Y | 103TC0700X | Clinical Psychologist | 2013-07 | KY |
NPI | 1164760757 |
---|---|
Provider Name | Krystal Marie Sharp |
First Address | New Castle, KY 40050-2521 |
Second Address | New Castle, KY 40050-2521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2013 |
Last Update Date | 16/01/2013 |