Provider Demographics
NPI:1720685407
Name:WOODWORTH, SYLVIAN ANALYN
Entity Type:Individual
Prefix:
First Name:SYLVIAN
Middle Name:ANALYN
Last Name:WOODWORTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANALYN
Other - Middle Name:
Other - Last Name:WOODWORTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5857
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77325-5857
Mailing Address - Country:US
Mailing Address - Phone:832-233-3086
Mailing Address - Fax:832-415-3050
Practice Address - Street 1:2323 TIMBER SHADOWS DR STE B
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2028
Practice Address - Country:US
Practice Address - Phone:832-233-3086
Practice Address - Fax:832-415-3050
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83571101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty