Healthcare Provider Details

I. General information

NPI: 1740917467
Provider Name (Legal Business Name): SYLVIA EPPES LBSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2022
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

882 OAKMAN BLVD
DETROIT MI
48238-3710
US

IV. Provider business mailing address

13914 ABINGTON AVE
DETROIT MI
48227-1302
US

V. Phone/Fax

Practice location:
  • Phone: 313-875-7601
  • Fax: 313-871-1891
Mailing address:
  • Phone: 313-587-8331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6802074897
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: