Individual
DR. SHARON ESTILL OLDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
125 S SWOOPE AVE STE 110, MAITLAND, FL 32751-5784
(407) 622-0444
(407) 699-0444
Mailing address
125 S SWOOPE AVE STE 110, MAITLAND, FL 32751-5784
(407) 622-0444
(407) 699-0444
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-00-0285
—
103T00000X
Psychologist
Primary
PY4781
FL
103TC0700X
Clinical Psychologist
PY4781
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY4781
FL
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PY4781
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
766320000
—
FL
Enumeration date
04/12/2007
Last updated
01/31/2023
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