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General NPI Number Information
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NPI Number | 1841468741
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Entity Type | Individual
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Provider Name | DIANNE LOUISE REYNOLDS M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 5335 WISCONSIN AVE NW SUITE 440
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City | WASHINGTON
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State | DC
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Zip | 20015-2030
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Country | US
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Telephone | 202-274-1814
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Fax |
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Provider Business Mailing Address
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Address Line | 5335 WISCONSIN AVE NW SUITE 440
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City | WASHINGTON
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State | DC
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Zip | 20015-2030
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Country | US
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Telephone | 202-274-1814
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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 | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD 31802
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101262771
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD 31802
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License Number State | DC
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