Provider Demographics
NPI:1396860052
Name:CHAVEZ, SYLVIA ANN (MS SLP CCC)
Entity Type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:ANN
Last Name:CHAVEZ
Suffix:
Gender:F
Credentials:MS SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 CALLE PO AEPI
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-7767
Mailing Address - Country:US
Mailing Address - Phone:505-467-4600
Mailing Address - Fax:
Practice Address - Street 1:3200 CALLE PO AEPI
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-7767
Practice Address - Country:US
Practice Address - Phone:505-467-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3732235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM60238712Medicaid