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General NPI Number Information
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NPI Number | 1891472932
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Entity Type | Individual
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Provider Name | KENDRA REYNOLDS MA, RMHCI
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Gender | Female
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Dates
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Enumeration Date | 06/30/2023
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 363 FENNELL BLVD
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City | LADY LAKE
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State | FL
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Zip | 32159-3185
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Country | US
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Telephone | 352-633-5253
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Fax |
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Provider Business Mailing Address
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Address Line | 825 BRIARWOOD CT
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City | ORANGE CITY
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State | FL
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Zip | 32763-4319
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Country | US
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Telephone | 954-806-9977
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 23848
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License Number State | FL
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