Provider Demographics
NPI:1255639902
Name:NOCKIDENEH-TEE, SYLVIA
Entity type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:
Last Name:NOCKIDENEH-TEE
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:PO BOX 3265
Mailing Address - Street 2:
Mailing Address - City:TUBA CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86045-3265
Mailing Address - Country:US
Mailing Address - Phone:928-283-1040
Mailing Address - Fax:928-283-1218
Practice Address - Street 1:EAST FIR STREET
Practice Address - Street 2:TUBA CITY JUNIOR HIGH
Practice Address - City:TUBA CITY
Practice Address - State:AZ
Practice Address - Zip Code:86045
Practice Address - Country:US
Practice Address - Phone:928-283-1040
Practice Address - Fax:928-283-1218
Is Sole Proprietor?:No
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4245568101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool