MEDICARE: MS. SYLMA FINE M.A., MFT, ATR-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	MFC 41633	CA
2	101YM0800X	Mental Health Counselor	MFC 41633	CA
3	106H00000X	Marriage & Family Therapist	0133601	NM
4	101YM0800X	Mental Health Counselor	0133601	NM

General Provider Information

NPI Number	:	1235107137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SYLMA FINE M.A., MFT, ATR-BC

Provider Business Mailing Address
First Line	:	PO BOX 25601
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87125-0601
Country	:	US
Telephone Number	:	505-553-6381
Fax Number	:

Provider Business Practice Location Address
First Line	:	6666 4TH ST NW
Second Line	:
City	:	LOS RANCHOS
State	:	NM
Zip	:	87107-6144
Country	:	US
Telephone Number	:	505-553-6381
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2006
Last Update Date	:	10/09/2012

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