Provider Demographics
NPI:1558768598
Name:SCHILLER, CRYSTAL ELIZABETH EDLER (PHD)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:ELIZABETH EDLER
Last Name:SCHILLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:ELIZABETH
Other - Last Name:EDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:234 MEDICAL SCHOOL WING C
Mailing Address - Street 2:CAMPUS BOX 7160
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7160
Mailing Address - Country:US
Mailing Address - Phone:919-966-4810
Mailing Address - Fax:919-966-5628
Practice Address - Street 1:234 MEDICAL SCHOOL WING C
Practice Address - Street 2:CAMPUS BOX 7160
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7160
Practice Address - Country:US
Practice Address - Phone:919-966-4810
Practice Address - Fax:919-966-5628
Is Sole Proprietor?:No
Enumeration Date:2014-11-19
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
NC4733103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist