Provider Demographics
NPI:1063293504
Name:SHARPE, SYDNEY CLAIRE
Entity type:Individual
Prefix:MRS
First Name:SYDNEY
Middle Name:CLAIRE
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 1:6080 LAKEVIEW RD APT 4206
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-9165
Mailing Address - Country:US
Mailing Address - Phone:386-292-4906
Mailing Address - Fax:
Practice Address - Street 1:6080 LAKEVIEW RD APT 4206
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-9165
Practice Address - Country:US
Practice Address - Phone:386-292-4906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-10
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-23-302097106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician