Provider Demographics
NPI:1699123190
Name:SHARP, LACEY LYNN (AUD)
Entity type:Individual
Prefix:DR
First Name:LACEY
Middle Name:LYNN
Last Name:SHARP
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:LACEY
Other - Middle Name:
Other - Last Name:BEHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:3225 CUMBERLAND BLVD SE STE 900
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5971
Mailing Address - Country:US
Mailing Address - Phone:404-351-2220
Mailing Address - Fax:
Practice Address - Street 1:3225 CUMBERLAND BLVD SE STE 175
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-6407
Practice Address - Country:US
Practice Address - Phone:404-591-2950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist