Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 35.091314 | OH |
NPI | 1770793523 |
---|---|
Provider Name | Dr. Susan Joyce Sabo |
First Address | Avon, OH 44011-0424 |
Second Address | Avon, OH 44011-5624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 28/12/2015 |