Healthcare Provider Details

I. General information

NPI: 1144167701
Provider Name (Legal Business Name): KARLYN MAKENNA REIGHARD RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 N MAIN ST
KILMARNOCK VA
22482-3822
US

IV. Provider business mailing address

5954 BROOKE PL
GLOUCESTER VA
23061-4177
US

V. Phone/Fax

Practice location:
  • Phone: 804-581-0008
  • Fax: 804-404-9550
Mailing address:
  • Phone: 804-581-0008
  • Fax: 804-404-9550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-532359
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: