Healthcare Provider Details

I. General information

NPI: 1013174119
Provider Name (Legal Business Name): SYLVIA A BRADD LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SYLVIA A BOYLE

II. Dates (important events)

Enumeration Date: 05/18/2008
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 FIFTH ST
DOVER NH
03820-2930
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7630
US

V. Phone/Fax

Practice location:
  • Phone: 603-883-0005
  • Fax:
Mailing address:
  • Phone: 253-346-0397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1862
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: