Individual
JOHNATHON RAYMOND SHARP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
402 LEGACY PARK, RIDGELAND, MS 39157-4315
(769) 233-7154
(718) 215-5311
Mailing address
9508 SCOTT ST, VANCLEAVE, MS 39565-9105
(228) 282-0162
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/08/2024
Last updated
09/15/2025
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