Individual
MRS. TRACY REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7404 DON DIEGO ST NE, ALBUQUERQUE, NM 87109-6379
(505) 559-0870
Mailing address
7404 DON DIEGO ST NE, ALBUQUERQUE, NM 87109-6379
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
04/28/2013
Last updated
04/28/2013
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