Provider Demographics
NPI:1497589840
Name:SYLVA, JOCLYN LEE
Entity type:Individual
Prefix:
First Name:JOCLYN
Middle Name:LEE
Last Name:SYLVA
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 1:130 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-3175
Mailing Address - Country:US
Mailing Address - Phone:304-657-1719
Mailing Address - Fax:
Practice Address - Street 1:130 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-3175
Practice Address - Country:US
Practice Address - Phone:304-657-1719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant