| Doctor Name: | LEIGH SHARMA |
| NPI Number: | 1013183284 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PSY003771 |
| Business Practice Address: | 4521 Thomas Jefferson St Caldwell, ID - 836055100 |
| Business Phone Number: | 2084544831 |
| Business Fax Number: | |
| Mailing Address: | 4521 Thomas Jefferson St, CALDWELL |
| State: | ID |
| Postal Code: | 836055100 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2008 |
| NPI Last Update Date: | 03/31/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PSY003771 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |