Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 3641-57 | WI |
Y | 103T00000X | Psychologist | 3641-57 | WI |
NPI | 1013144252 |
---|---|
Provider Name | Prachi Sharma |
First Address | Milwaukee, WI 53220-3849 |
Second Address | Milwaukee, WI 53220-3849 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2009 |
Last Update Date | 20/03/2019 |