Provider Demographics
NPI:1083998587
Name:REYNOLDS, HALEY ALICE' (ALC)
Entity Type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:ALICE'
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 E SOUTH BLVD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-2312
Mailing Address - Country:US
Mailing Address - Phone:334-286-1746
Mailing Address - Fax:334-288-0219
Practice Address - Street 1:1060 E SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2312
Practice Address - Country:US
Practice Address - Phone:334-286-1746
Practice Address - Fax:334-288-0219
Is Sole Proprietor?:No
Enumeration Date:2011-10-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC1882A101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor