Provider Demographics
NPI:1215051032
Name:MILLNER, SHARON S
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:S
Last Name:MILLNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:S
Other - Last Name:MILLNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MED CCC-SLP
Mailing Address - Street 1:PO BOX 6125
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-6125
Mailing Address - Country:US
Mailing Address - Phone:434-963-3805
Mailing Address - Fax:
Practice Address - Street 1:103 S PANTOPS DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8617
Practice Address - Country:US
Practice Address - Phone:434-963-3805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202002928235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist