Provider Demographics
NPI:1073753554
Name:WHITAKER REYNOLDS, ERIN (PSYD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:WHITAKER REYNOLDS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:WHITAKER REYNOLDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3800 GAYLORD PKWY STE 910
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9419
Mailing Address - Country:US
Mailing Address - Phone:469-800-7540
Mailing Address - Fax:469-800-7545
Practice Address - Street 1:3800 GAYLORD PKWY STE 910
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9419
Practice Address - Country:US
Practice Address - Phone:469-800-7540
Practice Address - Fax:469-800-7545
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37701103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist