Provider Demographics
NPI:1528393998
Name:SYLVESTER, GLORIA B
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:B
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 ARCADIA DR
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-4370
Mailing Address - Country:US
Mailing Address - Phone:205-887-0888
Mailing Address - Fax:
Practice Address - Street 1:3016 PINECREST RD
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-1324
Practice Address - Country:US
Practice Address - Phone:205-633-3635
Practice Address - Fax:205-633-3644
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health