Individual
CARLY REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2425 STOCKTON BLVD, SACRAMENTO, CA 95817-2215
(916) 453-2240
Mailing address
2425 STOCKTON BLVD, SACRAMENTO, CA 95817-2215
(916) 453-2240
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7966
CA
Other
Enumeration date
09/19/2016
Last updated
10/08/2019
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