Provider Demographics
NPI:1235107137
Name:FINE, SYLMA (MA, MFT, ATR-BC)
Entity Type:Individual
Prefix:MS
First Name:SYLMA
Middle Name:
Last Name:FINE
Suffix:
Gender:F
Credentials:MA, MFT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25601
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-0601
Mailing Address - Country:US
Mailing Address - Phone:505-553-6381
Mailing Address - Fax:
Practice Address - Street 1:6666 4TH ST NW
Practice Address - Street 2:
Practice Address - City:LOS RANCHOS
Practice Address - State:NM
Practice Address - Zip Code:87107-6144
Practice Address - Country:US
Practice Address - Phone:505-553-6381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 41633101YA0400X, 101YM0800X
NM0133601106H00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health