Provider Demographics
NPI:1275287765
Name:KNOTTS, SYLVIA M (SOCIAL WORKER)
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:M
Last Name:KNOTTS
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:M
Other - Last Name:KNOTTS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SOCIAL WORKER
Mailing Address - Street 1:PO BOX 2064
Mailing Address - Street 2:
Mailing Address - City:MILAN
Mailing Address - State:NM
Mailing Address - Zip Code:87021-2064
Mailing Address - Country:US
Mailing Address - Phone:505-658-9164
Mailing Address - Fax:
Practice Address - Street 1:2105 HASLER VALLEY RD.
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-8730
Practice Address - Country:US
Practice Address - Phone:505-847-5795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
NMSWB-2023-0433104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator