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Individual

MRS. STACI DAHNAL REYNOLDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
221 KINNEY DR, WOOSTER, OH 44691-1618
(330) 466-5697
Mailing address
221 KINNEY DR, WOOSTER, OH 44691-1618
(330) 466-5697

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-25225
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0347538
OH
Enumeration date
04/17/2017
Last updated
05/29/2019
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