Individual
MRS. MITZI ELLA REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 WINSTON WAY STE 1, CAMPBELLSVILLE, KY 42718-4953
(270) 849-2157
(888) 975-1981
Mailing address
790 MCELROY PIKE, LEBANON, KY 40033-9368
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
104279
KY
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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