Provider Demographics
NPI:1801406798
Name:SYBERT, EMILY VICTORIA
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:VICTORIA
Last Name:SYBERT
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 1:55 STEDMAN CIR
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-2378
Mailing Address - Country:US
Mailing Address - Phone:860-508-5304
Mailing Address - Fax:
Practice Address - Street 1:35 OLD SOUTH RD
Practice Address - Street 2:
Practice Address - City:NANTUCKET
Practice Address - State:MA
Practice Address - Zip Code:02554-2895
Practice Address - Country:US
Practice Address - Phone:800-444-1554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker