Provider Demographics
NPI:1275852923
Name:SYLVESTER, LISA R (MS)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:R
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 RANCHOAK DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-4940
Mailing Address - Country:US
Mailing Address - Phone:405-243-7759
Mailing Address - Fax:
Practice Address - Street 1:806 RANCHOAK DR
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-4940
Practice Address - Country:US
Practice Address - Phone:405-243-7759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-20
Last Update Date:2010-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health