Provider Demographics
NPI:1235830399
Name:KERR, SYDNEY LOUISE
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:LOUISE
Last Name:KERR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 PORTOBELLO RD
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-8613
Mailing Address - Country:US
Mailing Address - Phone:828-707-3201
Mailing Address - Fax:
Practice Address - Street 1:107 PORTOBELLO RD
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-8613
Practice Address - Country:US
Practice Address - Phone:828-707-3201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
NC000047623604106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician