Provider Demographics
NPI:1528827573
Name:SHARP, RACHELLE JONIQUE
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:JONIQUE
Last Name:SHARP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 NW 41ST ST
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33309-4863
Mailing Address - Country:US
Mailing Address - Phone:954-932-6283
Mailing Address - Fax:
Practice Address - Street 1:3500 NW 41ST ST
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33309-4863
Practice Address - Country:US
Practice Address - Phone:954-939-4880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist