Individual
KEVIN BRENT REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II
Contact information
Practice address
401 NE BURNSIDE AVE, BEND, OR 97701-5122
(541) 508-8429
Mailing address
401 NE BURNSIDE AVE, BEND, OR 97701-5122
(541) 508-8429
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15-06-21
OR
Other
Enumeration date
02/24/2015
Last updated
09/28/2022
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