Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 3261 | OH |
Y | 103TC1900X | Counseling Psychologist | 3261 | OH |
NPI | 1104155118 |
---|---|
Provider Name | Dr. Stephen Marc Silling |
First Address | Tallmadge, OH 44278-1329 |
Second Address | Tallmadge, OH 44278-1329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2009 |
Last Update Date | 22/12/2009 |