Doctor Name: | COLETTE R REYNOLDS |
NPI Number: | 1538221213 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA CCC |
License Number: | 2202001160 |
Business Practice Address: | 183 Keith St # 4 Warrenton, VA - 201863231 |
Business Phone Number: | 5403471239 |
Business Fax Number: | |
Mailing Address: | 183 Keith St # 4, WARRENTON |
State: | VA |
Postal Code: | 201863231 |
Phone Number: | 5403471239 |
Fax Number: | |
NPI Enumeration Date: | 12/15/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202001160 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |