Provider Demographics
NPI:1043347305
Name:RICH, SIBYL WILLETTE
Entity Type:Individual
Prefix:MS
First Name:SIBYL
Middle Name:WILLETTE
Last Name:RICH
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 1:295 WHETHERBINE WAY E
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-8528
Mailing Address - Country:US
Mailing Address - Phone:850-671-6616
Mailing Address - Fax:
Practice Address - Street 1:1801 MICCOSUKEE COMMONS DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5433
Practice Address - Country:US
Practice Address - Phone:850-921-0330
Practice Address - Fax:850-921-0283
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker