Provider Demographics
NPI:1063561637
Name:SUTTON, SHARON LYNN (OTRL)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNN
Last Name:SUTTON
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4236 MCFARLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-2814
Mailing Address - Country:US
Mailing Address - Phone:205-339-0900
Mailing Address - Fax:205-339-0991
Practice Address - Street 1:4236 MCFARLAND BLVD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-2814
Practice Address - Country:US
Practice Address - Phone:205-339-0900
Practice Address - Fax:205-339-0991
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0178225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51505518SUTOtherBCBS PROVIDER
AL51505518SUTOtherBCBS PROVIDER