MEDICARE: SABRINA L STILES CDCA

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CDCA.164620	OH

General Provider Information

NPI Number	:	1215434352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SABRINA L STILES CDCA

Provider Business Mailing Address
First Line	:	135 WILLIAMS ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-4601
Country	:	US
Telephone Number	:	513-827-6281
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 WILLIAMS ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45215-4601
Country	:	US
Telephone Number	:	513-827-6281
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2018
Last Update Date	:	04/06/2018

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