Healthcare Provider Details

I. General information

NPI: 1205695327
Provider Name (Legal Business Name): STABRETIA DANIELLE LITWILER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 3RD AVE
CHESAPEAKE OH
45619-1074
US

IV. Provider business mailing address

305 N 5TH ST
IRONTON OH
45638-1578
US

V. Phone/Fax

Practice location:
  • Phone: 740-867-6687
  • Fax:
Mailing address:
  • Phone: 740-867-6687
  • Fax: 740-867-5555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: