Provider Demographics
NPI:1477886414
Name:BALTAZAR, SYLVIA (LMSW)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:BALTAZAR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W. 21ST
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101
Mailing Address - Country:US
Mailing Address - Phone:575-769-2345
Mailing Address - Fax:575-769-9013
Practice Address - Street 1:400 N PENNSYLVANIA AVE STE 670B
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-4755
Practice Address - Country:US
Practice Address - Phone:575-769-2345
Practice Address - Fax:575-769-9013
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-09
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool