Healthcare Provider Details

I. General information

NPI: 1548271547
Provider Name (Legal Business Name): MAURO REYNOLDS & ASSOCIATES IN COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 09/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5341 W ATLANTIC AVE SUITE 304
DELRAY BEACH FL
33484-8167
US

IV. Provider business mailing address

5341 W ATLANTIC AVE SUITE 304
DELRAY BEACH FL
33484-8167
US

V. Phone/Fax

Practice location:
  • Phone: 561-498-7542
  • Fax: 561-499-4378
Mailing address:
  • Phone: 561-498-7542
  • Fax: 561-499-4378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3790
License Number StateFL

VIII. Authorized Official

Name: DR. CYNTHIA LOUISE REYNOLDS
Title or Position: CLINICAL DIRECTOR
Credential: PSY.D.
Phone: 561-498-7542