MEDICARE: MISS BRITTANY INEZ-KRSYTAL REYNOLDS MS, LPC, NCC

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	101YM0800X	Mental Health Counselor	84374	TX

General Provider Information

NPI Number	:	1184202160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS BRITTANY INEZ-KRSYTAL REYNOLDS MS, LPC, NCC

Provider Business Mailing Address
First Line	:	1910 PACIFIC AVE STE 12020
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-4529
Country	:	US
Telephone Number	:	214-233-6019
Fax Number	:

Provider Business Practice Location Address
First Line	:	1910 PACIFIC AVE STE 12020
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-4529
Country	:	US
Telephone Number	:	214-233-6019
Fax Number	:

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

Provider Enumeration Date	:	03/31/2021
Last Update Date	:	04/25/2023

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