Provider Demographics
NPI:1811501190
Name:SABYRKULOVA, SABINA RAMILIEVNA
Entity type:Individual
Prefix:
First Name:SABINA
Middle Name:RAMILIEVNA
Last Name:SABYRKULOVA
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 1:501 E FRONT ST STE 513
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-5209
Mailing Address - Country:US
Mailing Address - Phone:406-565-6912
Mailing Address - Fax:
Practice Address - Street 1:2508 WILSON ST
Practice Address - Street 2:
Practice Address - City:MILES CITY
Practice Address - State:MT
Practice Address - Zip Code:59301-5000
Practice Address - Country:US
Practice Address - Phone:406-234-0234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-PCLC-LIC-44159101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health