Individual
MISS REBECCA REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADCR
Contact information
Practice address
1485 MARKET ST, SPRINGFIELD, OR 97477-3337
(541) 653-8284
Mailing address
1485 MARKET ST, SPRINGFIELD, OR 97477-3337
(541) 653-8284
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-23-2602
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T-23-2602
MHACBO
OR
Enumeration date
07/18/2023
Last updated
07/18/2023
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