Individual
AMY REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
467 CREAMERY WAY, EXTON, PA 19341-2508
(610) 363-1488
Mailing address
414 5TH AVE, PARKESBURG, PA 19365-1439
(484) 712-5758
(484) 712-5758
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH003598
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007727350084
—
PA
Enumeration date
10/19/2017
Last updated
10/19/2017
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