Provider Demographics
NPI:1861102527
Name:SKARDA, SYDNEY KATHERINE (MOTR/L)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:KATHERINE
Last Name:SKARDA
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 E ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-9256
Mailing Address - Country:US
Mailing Address - Phone:402-686-0567
Mailing Address - Fax:
Practice Address - Street 1:700 W STEVENS ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-4958
Practice Address - Country:US
Practice Address - Phone:575-234-3305
Practice Address - Fax:575-725-5999
Is Sole Proprietor?:No
Enumeration Date:2022-12-02
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMOT-2024-0070225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist