Organization
ROYAL IVEY WELLNESS, INC.
Active
Other names
Keysha A. Reynolds
Organization subpart
No
Provider details
NPI number
Authorized official
KEYSHA REYNOLDS NCC, LPC (COUNSELOR/OWNER)
(803) 747-4325
Entity
Organization
Contact information
Practice address
2712 MIDDLEBURG DR STE 206, COLUMBIA, SC 29204-2415
(803) 757-4325
Mailing address
2712 MIDDLEBURG DR STE 206, COLUMBIA, SC 29204-2415
(803) 757-4325
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
6380
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1741
—
SC
Enumeration date
06/26/2017
Last updated
06/26/2017
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