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NPI Code Detail

MEDICARE: SYDNEY M ROBERTS

MEDICARE:   SYDNEY M ROBERTS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor179857OH

General Provider Information

NPI Number : 1194473587
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY M ROBERTS
Provider Business Mailing Address
First Line : 6830 BRANDT PIKE APT A
Second Line :
City : HUBER HEIGHTS
State : OH
Zip : 45424-3380
Country : US
Telephone Number : 937-965-2935
Fax Number :
Provider Business Practice Location Address
First Line : 6830 BRANDT PIKE APT A
Second Line :
City : HUBER HEIGHTS
State : OH
Zip : 45424-3380
Country : US
Telephone Number : 937-965-2935
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2022
Last Update Date : 03/14/2022

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Directions to “ SYDNEY M ROBERTS ” Practice Location

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