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NPI Code Detail

MEDICARE: ALEXANDRA REYNOLDS

MEDICARE: ALEXANDRA REYNOLDS
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1649977380
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXANDRA REYNOLDS
Provider Business Mailing Address
First Line : 8320 N POPLAR DR
Second Line :
City : FOX POINT
State : WI
Zip : 53217-2826
Country : US
Telephone Number : 262-271-8466
Fax Number :
Provider Business Practice Location Address
First Line : 6140 W EXECUTIVE DR
Second Line :
City : MEQUON
State : WI
Zip : 53092-4499
Country : US
Telephone Number : 888-946-5037
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2023
Last Update Date : 02/13/2023

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Directions to “ ALEXANDRA REYNOLDS ” Practice Location

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