Individual
MS. JEANMARIE REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
75 MIDLAND AVE, MARYLAND HEIGHTS, MO 63043-2625
(314) 583-8377
Mailing address
2784 CORRAL EST, ARNOLD, MO 63010-4102
(314) 583-8377
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2000171103
MO
101YP2500X
Professional Counselor
Primary
2000171103
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001273705
CTS VENDOR NUMBER
MO
01
—
164436
BLUE CROSS BLUE SHIELD
MO
05
—
494847809
—
MO
Enumeration date
11/16/2006
Last updated
01/12/2024
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