Doctor Name: | MS. RHONDA REYNOLDS |
NPI Number: | 1053745125 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M-RAS |
License Number: | R0702201609 |
Business Practice Address: | 139 Ford St Ukiah, CA - 954824011 |
Business Phone Number: | 7074621934 |
Business Fax Number: | |
Mailing Address: | 3720a Connie Ln, KELSEYVILLE |
State: | CA |
Postal Code: | 954518086 |
Phone Number: | 7074138649 |
Fax Number: | |
NPI Enumeration Date: | 08/26/2013 |
NPI Last Update Date: | 08/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | R0702201609 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |