Healthcare Provider Details

I. General information

NPI: 1891284386
Provider Name (Legal Business Name): MYLES EVAN SILAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 05/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1210 N W WASHINGTON BLVD #4
HAMILTON OH
45011
US

IV. Provider business mailing address

1210 N W WASHINGTON BLVD #4
HAMILTON OH
45011
US

V. Phone/Fax

Practice location:
  • Phone: 513-795-7557
  • Fax:
Mailing address:
  • Phone: 513-795-7557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: