Provider Demographics
NPI:1497173876
Name:SYKES, NAKEENA (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NAKEENA
Middle Name:
Last Name:SYKES
Suffix:
Gender:F
Credentials:MA CCC-SLP
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 302
Mailing Address - Street 2:
Mailing Address - City:ELLENBURG DEPOT
Mailing Address - State:NY
Mailing Address - Zip Code:12935-0302
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1394 PLANK RD
Practice Address - Street 2:BOX 302
Practice Address - City:ELLENBURG DEPOT
Practice Address - State:NY
Practice Address - Zip Code:12935
Practice Address - Country:US
Practice Address - Phone:215-970-4774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023501-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist