Individual
CARISA REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
718 COLUMBIA ST, NEWPORT, KY 41071-1837
(859) 331-3292
(859) 578-2864
Mailing address
502 FARRELL DR, COVINGTON, KY 41011-3717
(859) 331-3292
(859) 578-2864
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/25/2018
Last updated
06/25/2018
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