Individual
DIANE L. REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LADC
Contact information
Practice address
390 RIVER ST., SPRINGFIELD, VT 05156
(802) 886-4500
(802) 886-4520
Mailing address
390 RIVER ST., SPRINGFIELD, VT 05156
(802) 886-4500
(802) 886-4520
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
000387
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
69315
BLUE CROSS
VT
Enumeration date
03/27/2007
Last updated
10/22/2008
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