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General NPI Number Information
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NPI Number | 1538533435
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Entity Type | Individual
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Provider Name | ALANA REYNOLDS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/16/2015
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Last Update Date | 09/24/2019
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Provider Practice Location Address
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Address Line | 419 HARDING ST
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City | CLAYTON
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State | NM
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Zip | 88415-3323
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Country | US
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Telephone | 413-626-6361
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Fax |
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Provider Business Mailing Address
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Address Line | 300 E PARK ST
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City | MARQUETTE
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State | MI
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Zip | 49855-3629
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Country | US
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Telephone |
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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 | 4067
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 11504
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License Number State | MA
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