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NPI Code Detail

MEDICARE: MRS. SUZANNE FISCHER REYNOLDS M.S.

MEDICARE: MRS. SUZANNE FISCHER REYNOLDS M.S.
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1902099740
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUZANNE FISCHER REYNOLDS M.S.
Provider Business Mailing Address
First Line : 550 RIVER RD
Second Line :
City : EUGENE
State : OR
Zip : 97404-3212
Country : US
Telephone Number : 541-689-8795
Fax Number : 541-689-1243
Provider Business Practice Location Address
First Line : 550 RIVER RD
Second Line :
City : EUGENE
State : OR
Zip : 97404-3212
Country : US
Telephone Number : 541-689-8795
Fax Number : 541-689-1243
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2007
Last Update Date : 08/24/2007

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