Provider Demographics
NPI:1467638825
Name:REGISTER, SYDNEY KROLL (PSYD)
Entity type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:KROLL
Last Name:REGISTER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:SYDNEY
Other - Middle Name:
Other - Last Name:KROLL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:518 E HOSPITAL ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-5239
Mailing Address - Country:US
Mailing Address - Phone:936-462-8577
Mailing Address - Fax:936-228-9072
Practice Address - Street 1:518 E HOSPITAL ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-5239
Practice Address - Country:US
Practice Address - Phone:936-462-8577
Practice Address - Fax:936-228-9072
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34032103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical