Provider Demographics
NPI:1255665709
Name:RODRIGUES, SYLVIA PUTTICK (OTR/L, CHT)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:PUTTICK
Last Name:RODRIGUES
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 DOVER AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-9795
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 S WHITING ST
Practice Address - Street 2:SUITE 108
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-3418
Practice Address - Country:US
Practice Address - Phone:703-370-0097
Practice Address - Fax:703-370-0916
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 12138225XH1200X
MA5269225XH1200X
VA0119004914225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand