Organization
NICOLE REYNOLDS PSYD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICOLE R REYNOLDS PSYD, LP (OWNER/OPERATOR)
(248) 736-5067
Entity
Organization
Contact information
Practice address
158 N MAIN ST, PLYMOUTH, MI 48170-1236
(248) 736-5067
Mailing address
20789 SUNNYDALE ST, FARMINGTON HILLS, MI 48336-5254
(248) 736-5067
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
6301016052
MI
Other
Enumeration date
02/17/2016
Last updated
02/17/2016
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