Individual
SAMUEL ANTONIO REYNOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2150 S COUNTRY CLUB DR, MESA, AZ 85210-6809
(480) 398-4280
Mailing address
PO BOX 50218, PHOENIX, AZ 85076-0218
(480) 398-4280
(844) 526-2649
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SLPA15782
AZ
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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