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NPI Code Detail

MEDICARE: MYLES A STICKLE LISW

MEDICARE: MYLES A STICKLE LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI0008971OH

General Provider Information

NPI Number : 1043280175
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYLES A STICKLE LISW
Provider Business Mailing Address
First Line : 1105 SCHROCK RD STE 400
Second Line :
City : COLUMBUS
State : OH
Zip : 43229-1174
Country : US
Telephone Number : 614-987-5620
Fax Number :
Provider Business Practice Location Address
First Line : 750 E LONG ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43203-1846
Country : US
Telephone Number : 614-340-6700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2006
Last Update Date : 05/31/2022

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Directions to “ MYLES A STICKLE LISW” Practice Location

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