Provider Demographics
NPI:1093051138
Name:SYLVESTER, REBECCA M (BS CACD-D)
Entity Type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:M
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:BS CACD-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3139 WEST HURON STREET
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328
Mailing Address - Country:US
Mailing Address - Phone:248-738-8400
Mailing Address - Fax:
Practice Address - Street 1:3139 W HURON ST
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-3636
Practice Address - Country:US
Practice Address - Phone:248-738-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)