Individual
MR. JACK EDWARD REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
5604 TIMBER LN, OKLAHOMA CITY, OK 73111-6877
(405) 816-7725
Mailing address
5604 TIMBER LN, OKLAHOMA CITY, OK 73111-6877
(405) 816-7725
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Enumeration date
03/30/2010
Last updated
03/30/2010
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