Provider Demographics
NPI:1356080600
Name:METHENEY, SABRA NICOLE
Entity Type:Individual
Prefix:
First Name:SABRA
Middle Name:NICOLE
Last Name:METHENEY
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 1:4068 FIELDHOUSE DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20742-1384
Mailing Address - Country:US
Mailing Address - Phone:240-620-3637
Mailing Address - Fax:877-863-2802
Practice Address - Street 1:3404 HAMPTON HOLLOW DR APT B
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-6182
Practice Address - Country:US
Practice Address - Phone:304-276-1915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT0066172255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer