Individual
SHARRON WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW, MS, ICP
Contact information
Practice address
6969 PASTOR BAILEY DR, SUITE 140, DALLAS, TX 75237-2636
(972) 298-3366
(214) 920-8494
Mailing address
6969 PASTOR BAILEY DR, SUITE 140, DALLAS, TX 75237-2636
(972) 298-3366
(214) 920-8494
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
03903
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171M00000X
—
TX
Enumeration date
06/17/2009
Last updated
06/17/2009
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