Provider Demographics
NPI:1386708717
Name:JULSONNET, SHARON K (PHD)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:K
Last Name:JULSONNET
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 BREAKERS WAY
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-2362
Mailing Address - Country:US
Mailing Address - Phone:954-384-9023
Mailing Address - Fax:
Practice Address - Street 1:1724 BREAKERS WAY
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-2362
Practice Address - Country:US
Practice Address - Phone:954-384-9023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4873103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59420ZMedicare ID - Type Unspecified