Provider Demographics
NPI:1477975746
Name:DIX-REYNOLDS, SYDNEY L (MSW)
Entity Type:Individual
Prefix:MRS
First Name:SYDNEY
Middle Name:L
Last Name:DIX-REYNOLDS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 PUBLIC AVE
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:PA
Mailing Address - Zip Code:18801-1220
Mailing Address - Country:US
Mailing Address - Phone:607-206-4799
Mailing Address - Fax:607-797-7601
Practice Address - Street 1:72 PUBLIC AVE
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:PA
Practice Address - Zip Code:18801-1220
Practice Address - Country:US
Practice Address - Phone:607-206-4799
Practice Address - Fax:607-797-7601
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst