Provider Demographics
NPI:1790548915
Name:EMILE, SYBIL
Entity Type:Individual
Prefix:
First Name:SYBIL
Middle Name:
Last Name:EMILE
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 1:4400 W HALLANDALE BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33023-4332
Mailing Address - Country:US
Mailing Address - Phone:305-921-4245
Mailing Address - Fax:
Practice Address - Street 1:4400 W HALLANDALE BEACH BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-4332
Practice Address - Country:US
Practice Address - Phone:305-921-4245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12370394103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst