Provider Demographics
NPI:1679639728
Name:ROBERTS, DEANDA SYLTE (MA)
Entity Type:Individual
Prefix:MRS
First Name:DEANDA
Middle Name:SYLTE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 W 7TH AVE
Mailing Address - Street 2:STE. 1-C
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2806
Mailing Address - Country:US
Mailing Address - Phone:509-624-7252
Mailing Address - Fax:509-624-6442
Practice Address - Street 1:705 W 7TH AVE
Practice Address - Street 2:STE. 1-C
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2806
Practice Address - Country:US
Practice Address - Phone:509-624-7252
Practice Address - Fax:509-624-6442
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5497101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health