MEDICARE: CHRISTINA NOEL REYNOLDS MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	266739	KY

General Provider Information

NPI Number	:	1033805122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA NOEL REYNOLDS MS, CCC-SLP

Provider Business Mailing Address
First Line	:	332 LINCOLN AVE
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40502-1518
Country	:	US
Telephone Number	:	606-499-5793
Fax Number	:

Provider Business Practice Location Address
First Line	:	1608 HILL RISE DR
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-2503
Country	:	US
Telephone Number	:	606-499-5793
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2023
Last Update Date	:	04/12/2023

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Directions to “ CHRISTINA NOEL REYNOLDS MS, CCC-SLP” Practice Location

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