MEDICARE: AMBER REYNOLDS MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	111635	TX

General Provider Information

NPI Number	:	1275086654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER REYNOLDS MS, CCC-SLP

Provider Business Mailing Address
First Line	:	113 TIMBERVIEW DR
Second Line	:
City	:	GRAHAM
State	:	TX
Zip	:	76450-1460
Country	:	US
Telephone Number	:	620-214-2424
Fax Number	:

Provider Business Practice Location Address
First Line	:	442 OAK ST
Second Line	:
City	:	GRAHAM
State	:	TX
Zip	:	76450-2522
Country	:	US
Telephone Number	:	940-247-0402
Fax Number	:	940-320-9540

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2016
Last Update Date	:	10/22/2025

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Directions to “ AMBER REYNOLDS MS, CCC-SLP” Practice Location

Language	Start Address	Practice Location

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