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Individual

MRS. LAKECIA MONIQUE REYNOLDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
302 CARLTON DR, JESUP, GA 31546-3426
(912) 202-6882
Mailing address
302 CARLTON DR, JESUP, GA 31546-3426
(912) 202-6882

Taxonomy

Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
251E00000X
Home Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
873064303
GA
Enumeration date
10/12/2021
Last updated
10/12/2021
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