Provider Demographics
NPI:1932427085
Name:RUCKER, SYLVIA (MSW)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:RUCKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20828 NW 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33056-5202
Mailing Address - Country:US
Mailing Address - Phone:786-486-9440
Mailing Address - Fax:
Practice Address - Street 1:20828 NW 24TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33056-5202
Practice Address - Country:US
Practice Address - Phone:786-486-9440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical