Individual
CAROLYN ELAINE REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
93 BROADLAWN, ARDMORE, OK 73401
(580) 223-2537
(580) 223-2487
Mailing address
93 BROADLAWN, ARDMORE, OK 73401
(580) 223-2537
(580) 223-2487
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
OK
Enumeration date
02/12/2008
Last updated
02/12/2008
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