Provider Demographics
NPI:1316266331
Name:SYKES, EVA JEAN (DT)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:JEAN
Last Name:SYKES
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HIGHWAY 142
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71653-6074
Mailing Address - Country:US
Mailing Address - Phone:870-265-4191
Mailing Address - Fax:870-265-4192
Practice Address - Street 1:422 ANNEX ST
Practice Address - Street 2:
Practice Address - City:LAKE VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71653-1809
Practice Address - Country:US
Practice Address - Phone:870-265-4191
Practice Address - Fax:870-265-4191
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-01
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist