Individual
DEBBIE REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
800 HICKORY AVE STE D, HARAHAN, LA 70123-3149
(504) 541-4601
Mailing address
575 HICKORY AVE, HARAHAN, LA 70123-3104
(504) 541-4601
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4765
LA
106H00000X
Marriage & Family Therapist
MFC 40743
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107318
SAN JOSE CITY ID #
CA
Enumeration date
06/29/2007
Last updated
06/28/2011
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