Provider Demographics
NPI:1932532348
Name:WANG, SHARON MIAO (MA)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:MIAO
Last Name:WANG
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 1:4285 SHERWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2173
Mailing Address - Country:US
Mailing Address - Phone:248-842-8510
Mailing Address - Fax:
Practice Address - Street 1:4285 SHERWOOD CIR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48188-2173
Practice Address - Country:US
Practice Address - Phone:248-842-8510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014899103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling