Provider Demographics
NPI:1295380038
Name:TOLLICK, SYDNEY REYNOLDS (MS)
Entity Type:Individual
Prefix:MRS
First Name:SYDNEY
Middle Name:REYNOLDS
Last Name:TOLLICK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:SYDNEY
Other - Middle Name:DANIELLE
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5110 YELLOW WATER RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32234-2420
Mailing Address - Country:US
Mailing Address - Phone:904-328-7526
Mailing Address - Fax:
Practice Address - Street 1:3027 SAN DIEGO RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-3691
Practice Address - Country:US
Practice Address - Phone:904-493-7744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health