Individual
DAVID AF RAYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC
Contact information
Practice address
600 SISKIYOU BLVD, ASHLAND, OR 97520-2140
(541) 821-6623
(541) 535-1778
Mailing address
PO BOX 503010, WHITE CITY, OR 97503-0813
(541) 941-7792
(503) 419-4662
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C0943
OR
103T00000X
Psychologist
C0943
OR
Other
Enumeration date
07/21/2006
Last updated
05/31/2012
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