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NPI Code Detail

MEDICARE: ASHLEY REYNOLDS

MEDICARE:   ASHLEY  REYNOLDS
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1578932356
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY REYNOLDS
Provider Business Mailing Address
First Line : 826 E CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-1512
Country : US
Telephone Number : 702-586-7409
Fax Number :
Provider Business Practice Location Address
First Line : 826 E CHARLESTON BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89104-1512
Country : US
Telephone Number : 702-586-7409
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2015
Last Update Date : 09/22/2015

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Directions to “ ASHLEY REYNOLDS ” Practice Location

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