Provider Demographics
NPI:1932479300
Name:BELL, SYLVIA LA-FAY (PHD07/30/1951)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:LA-FAY
Last Name:BELL
Suffix:
Gender:F
Credentials:PHD07/30/1951
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 SW SUNSET BLVD STE B-103
Mailing Address - Street 2:PO BOX 4158
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2320
Mailing Address - Country:US
Mailing Address - Phone:452-525-5552
Mailing Address - Fax:425-255-5523
Practice Address - Street 1:220 SW SUNSET BLVD STE B-103
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2320
Practice Address - Country:US
Practice Address - Phone:452-525-5552
Practice Address - Fax:425-255-5523
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60152487101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health