Provider Demographics
NPI:1003371204
Name:REYNOLDS, PAIGE MONIQUE (ALC, NCC)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:MONIQUE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:ALC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 W VALLEY AVE # 157
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-3691
Mailing Address - Country:US
Mailing Address - Phone:205-675-6592
Mailing Address - Fax:205-278-5526
Practice Address - Street 1:181 W VALLEY AVE # 157
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-3691
Practice Address - Country:US
Practice Address - Phone:205-675-6592
Practice Address - Fax:205-278-5526
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-01
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health