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Individual

MRS. AMY H REYNOLDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, LADC, CCS

Contact information

Practice address
25 MIDDLE ST, PORTLAND, ME 04101-4869
(207) 756-4455
Mailing address
10 OAK RIDGE DR, STANDISH, ME 04084-6019
(207) 756-4455

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC17205
ME
106E00000X
Assistant Behavior Analyst
LC17205
ME

Other

Enumeration date
11/04/2020
Last updated
11/04/2020
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