Provider Demographics
NPI:1770865966
Name:SYLVIA, CARI SUE
Entity type:Individual
Prefix:MS
First Name:CARI
Middle Name:SUE
Last Name:SYLVIA
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 1:11957 W RADER DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-1077
Mailing Address - Country:US
Mailing Address - Phone:208-422-1000
Mailing Address - Fax:208-422-1146
Practice Address - Street 1:500 W FORT ST
Practice Address - Street 2:V A MEDICAL CENTER (B-114)
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-4598
Practice Address - Country:US
Practice Address - Phone:208-422-1000
Practice Address - Fax:208-422-1146
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor