Individual
DANIELLE REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHA III
Contact information
Practice address
AIRPORT ROAD 151, SAVOONGA, AK 99769
(907) 984-6513
(907) 984-6068
Mailing address
P.O. BOX 151, SAVOONGA, AK 99769
(907) 984-6513
(907) 984-6068
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
12-1172-III
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12-1172-III
CHA III
AK
Enumeration date
01/30/2012
Last updated
01/30/2012
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