Provider Demographics
NPI:1275986184
Name:REYNOLDS, ANNA (MA, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MA, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51-636 KAMEHAMEHA HWY APT 124
Mailing Address - Street 2:
Mailing Address - City:KAAAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96730-9822
Mailing Address - Country:US
Mailing Address - Phone:214-202-5483
Mailing Address - Fax:
Practice Address - Street 1:51-636 KAMEHAMEHA HWY APT 124
Practice Address - Street 2:
Practice Address - City:KAAAWA
Practice Address - State:HI
Practice Address - Zip Code:96730-9822
Practice Address - Country:US
Practice Address - Phone:808-246-3102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst