Provider Demographics
NPI:1649355868
Name:LOMBARDO, SYLVIE A (PHD)
Entity type:Individual
Prefix:DR
First Name:SYLVIE
Middle Name:A
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 S MAIN ST
Mailing Address - Street 2:SUITE 270
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-2631
Mailing Address - Country:US
Mailing Address - Phone:248-586-0123
Mailing Address - Fax:248-591-9104
Practice Address - Street 1:123 S MAIN ST
Practice Address - Street 2:SUITE 270
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-2631
Practice Address - Country:US
Practice Address - Phone:248-586-0123
Practice Address - Fax:248-591-9104
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012353103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical