| Doctor Name: | KELSEY SYLVESTER |
| NPI Number: | 1063841518 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | A1309118 |
| Business Practice Address: | 715 N College Ave El Dorado, AR - 717304403 |
| Business Phone Number: | 8708627921 |
| Business Fax Number: | 8708642490 |
| Mailing Address: | 715 N College Ave, EL DORADO |
| State: | AR |
| Postal Code: | 717304403 |
| Phone Number: | 8708627921 |
| Fax Number: | 8708642490 |
| NPI Enumeration Date: | 11/05/2013 |
| NPI Last Update Date: | 11/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | A1309118 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |