Provider Demographics
NPI:1528304557
Name:SHARMA, SHEENA (MA)
Entity type:Individual
Prefix:MISS
First Name:SHEENA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3278 GEMINI DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-3175
Mailing Address - Country:US
Mailing Address - Phone:313-384-9091
Mailing Address - Fax:
Practice Address - Street 1:31700 W 12 MILE RD STE 250
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-4462
Practice Address - Country:US
Practice Address - Phone:313-384-9091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2319544103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist