Individual
MS. MAREDA LYNN REYNOLDS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
200 KANAWHA TER, SUITE 103, SAINT ALBANS, WV 25177-2867
(304) 727-1302
(304) 727-1302
Mailing address
PO BOX 904, SAINT ALBANS, WV 25177-0904
(304) 727-1302
(304) 727-1302
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
790
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9204038000
—
WV
01
—
W41480
BLUE CROSS/BLUE SHIELD
WV
Enumeration date
07/02/2005
Last updated
07/09/2007
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