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General NPI Number Information
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NPI Number | 1497877781
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Entity Type | Individual
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Provider Name | EMILY L REYNOLDS MS, OTR
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Gender | Female
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 101 S MERIDIAN ST RM 209
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City | PORTLAND
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State | IN
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Zip | 47371-2112
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Country | US
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Telephone | 812-480-0654
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Fax |
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Provider Business Mailing Address
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Address Line | 1831 W STATE ROAD 28
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City | RIDGEVILLE
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State | IN
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Zip | 47380-9256
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Country | US
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Telephone | 812-480-0654
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 31004354A
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License Number State | IN
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