Provider Demographics
NPI:1114007077
Name:REYNOLDS, ELIZABETH MAIER (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MAIER
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:MAIER
Other - Last Name:YOON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:12801 HAMLET HILL WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7250
Mailing Address - Country:US
Mailing Address - Phone:703-803-7971
Mailing Address - Fax:
Practice Address - Street 1:12801 HAMLET HILL WAY
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7250
Practice Address - Country:US
Practice Address - Phone:703-803-7971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010390342084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry