| Doctor Name: | SHARON HELENA WILLIS |
| NPI Number: | 1053620559 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BCABA |
| License Number: | |
| Business Practice Address: | 1980 N Atlantic Ave Ste 416 Cocoa Beach, FL - 329313272 |
| Business Phone Number: | 3216133823 |
| Business Fax Number: | |
| Mailing Address: | 1980 N Atlantic Ave Ste 416, COCOA BEACH |
| State: | FL |
| Postal Code: | 329313272 |
| Phone Number: | 3216133823 |
| Fax Number: | |
| NPI Enumeration Date: | 09/30/2010 |
| NPI Last Update Date: | 09/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |