Individual
CAITLYN REYNOSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5310 E 31ST ST, TULSA, OK 74135-5012
(918) 600-3100
Mailing address
2400 WATERMARK BLVD APT 2323, OKLAHOMA CITY, OK 73134-5178
(567) 203-2483
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/02/2021
Last updated
05/22/2025
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