Individual
MR. GREGORY HOMAN REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW, LADC
Contact information
Practice address
451 LEXINGTON PKWY N, SAINT PAUL, MN 55104-4636
(651) 280-2310
(651) 280-3995
Mailing address
451 LEXINGTON PKWY N, SAINT PAUL, MN 55104-4636
(651) 280-2310
(651) 280-3995
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
24431
NY
101YA0400X
Addiction (Substance Use Disorder) Counselor
301886
MN
1041C0700X
Clinical Social Worker
Primary
28771
MN
Other
Enumeration date
12/02/2011
Last updated
01/13/2021
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