Provider Demographics
NPI:1255045746
Name:SYLVAN PSYCHOLOGICAL, PLLC
Entity type:Organization
Organization Name:SYLVAN PSYCHOLOGICAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:SYLVAN
Authorized Official - Suffix:
Authorized Official - Credentials:LP
Authorized Official - Phone:734-780-4746
Mailing Address - Street 1:206 S MAIN ST
Mailing Address - Street 2:STE 205
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-2114
Mailing Address - Country:US
Mailing Address - Phone:734-780-4746
Mailing Address - Fax:
Practice Address - Street 1:206 S MAIN ST
Practice Address - Street 2:STE 205
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2114
Practice Address - Country:US
Practice Address - Phone:734-780-4746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty