Provider Demographics
NPI:1447533583
Name:SYKES, DEBORAH (LAC)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:SYKES
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 WALL ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-3528
Mailing Address - Country:US
Mailing Address - Phone:802-885-7056
Mailing Address - Fax:802-885-1600
Practice Address - Street 1:160 WALL ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-3528
Practice Address - Country:US
Practice Address - Phone:802-885-7056
Practice Address - Fax:802-885-1600
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT091-0000061171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist