Healthcare Provider Details

I. General information

NPI: 1962326595
Provider Name (Legal Business Name): BOBBI JO REYNOLDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 SERGEANT RD STE 230
SIOUX CITY IA
51106-4776
US

IV. Provider business mailing address

926 S ALICE ST
SIOUX CITY IA
51106-1501
US

V. Phone/Fax

Practice location:
  • Phone: 515-207-5251
  • Fax:
Mailing address:
  • Phone: 515-207-5251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: