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General NPI Number Information
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NPI Number | 1689720609
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Entity Type | Organization
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Legal Business Name | FRANK REYNOLDS, PH.D., P.C.
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 06/02/2008
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Provider Practice Location Address
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Address Line | 1604 HILLTOP WEST SHOPPING CTR SUITE 217
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-6141
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Country | US
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Telephone | 757-422-4801
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Fax | 757-422-1259
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Provider Business Mailing Address
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Address Line | 1604 HILLTOP WEST SHOPPING CTR SUITE 217
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City | VIRGINIA BEACH
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State | VA
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Zip | 23451-6141
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Country | US
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Telephone | 757-422-4801
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Fax | 757-422-1259
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Authorized Official
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Title or Position | OWNER
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Name | FRANK G REYNOLDS
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Credential | PH.D.
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Telephone | 757-422-4801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810001257
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License Number State | VA
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