Individual
MR. CHARLES HENRY REYNOLDS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MRE, CADC I
Contact information
Practice address
504 NE 18TH AVE, HILLSBORO, OR 97124-3508
(503) 348-6425
(503) 595-3478
Mailing address
504 NE 18TH AVE, HILLSBORO, OR 97124-3508
(503) 595-3478
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15-09-18
OR
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
10/16/2015
Last updated
10/20/2016
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