Provider Demographics
NPI:1922987197
Name:MAHAN, SABRINA MARIE
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:MARIE
Last Name:MAHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 CASTANEA DR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-2108
Mailing Address - Country:US
Mailing Address - Phone:513-338-4633
Mailing Address - Fax:
Practice Address - Street 1:109 CASTANEA DR
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-2108
Practice Address - Country:US
Practice Address - Phone:513-338-4633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-30
Last Update Date:2025-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program