Provider Demographics
NPI:1881709020
Name:EDMONDSON, SYLVIE LYNN (OT)
Entity type:Individual
Prefix:
First Name:SYLVIE
Middle Name:LYNN
Last Name:EDMONDSON
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4980 W SAHARA AVE STE 260
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-3435
Mailing Address - Country:US
Mailing Address - Phone:702-820-5070
Mailing Address - Fax:702-945-0314
Practice Address - Street 1:4980 W SAHARA AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-3402
Practice Address - Country:US
Practice Address - Phone:702-820-5070
Practice Address - Fax:702-945-0314
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0613225X00000X
0613225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1881709020Medicaid