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Individual
SHARA LEE M MAIN
Active
Individual
SHARA LEE M MAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
PENDING
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000663190
BCBS PIN
MT
Enumeration date
12/18/2007
Last updated
07/15/2015
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