Provider Demographics
NPI:1386770758
Name:PEARSON, SHARI ROTTBLATT (PHD)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:ROTTBLATT
Last Name:PEARSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SHARI
Other - Middle Name:JULIE
Other - Last Name:ROTTBLATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:6208 FAYETTEVILLE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6286
Mailing Address - Country:US
Mailing Address - Phone:919-699-0625
Mailing Address - Fax:
Practice Address - Street 1:6208 FAYETTEVILLE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6286
Practice Address - Country:US
Practice Address - Phone:919-699-0625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4192103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical