Provider Demographics
NPI:1669690178
Name:SACILOTTO-SHARKEY, MIRELLA ELISA (PHD)
Entity type:Individual
Prefix:MS
First Name:MIRELLA
Middle Name:ELISA
Last Name:SACILOTTO-SHARKEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 N FARWELL AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-2328
Mailing Address - Country:US
Mailing Address - Phone:414-223-4748
Mailing Address - Fax:
Practice Address - Street 1:1519 N FARWELL AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2328
Practice Address - Country:US
Practice Address - Phone:414-223-4748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst