Individual
MARY J REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LP
Contact information
Practice address
620 BABCOCK BLVD E, DELANO, MN 55328-8603
(763) 567-0078
Mailing address
PO BOX 404, DELANO, MN 55328-0404
(763) 567-0078
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2809
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
802025600
—
MN
Enumeration date
03/31/2006
Last updated
08/16/2023
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