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Individual

DR. SYDJEA M GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1230 N KIMBALL AVE STE 130, SOUTHLAKE, TX 76092-4707
(833) 667-7924
(817) 755-0945
Mailing address
126 FLOYD ST, BRENTWOOD, NY 11717-2646
(631) 336-0695

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
39576
TX

Other

Enumeration date
09/21/2022
Last updated
09/21/2022
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