Provider Demographics
NPI:1073367553
Name:STEPHANIE REYNOLDS, NATUROPATH, LLC
Entity Type:Organization
Organization Name:STEPHANIE REYNOLDS, NATUROPATH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:NATUROPATH/DOULA
Authorized Official - Phone:707-972-8933
Mailing Address - Street 1:791 E SCHOOL WAY
Mailing Address - Street 2:
Mailing Address - City:REDWOOD VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95470
Mailing Address - Country:US
Mailing Address - Phone:707-972-8933
Mailing Address - Fax:
Practice Address - Street 1:791 E SCHOOL WAY
Practice Address - Street 2:
Practice Address - City:REDWOOD VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95470
Practice Address - Country:US
Practice Address - Phone:707-972-8933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty