Individual
SHARON JEANNE EZOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., HSPP
Contact information
Practice address
526 N MARTIN AVE, MUNCIE, IN 47303-3537
(765) 287-1922
Mailing address
526 N MARTIN AVE, MUNCIE, IN 47303-3537
(765) 287-1922
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20041859A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000345066
BCBS
IN
Enumeration date
11/09/2006
Last updated
07/08/2007
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