Provider Demographics
NPI:1346755949
Name:REYNOLDS, LORI ANN (QMHS)
Entity Type:Individual
Prefix:MS
First Name:LORI
Middle Name:ANN
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:QMHS
Mailing Address - Street 1:150 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44481-1141
Mailing Address - Country:US
Mailing Address - Phone:330-394-6342
Mailing Address - Fax:330-394-6029
Practice Address - Street 1:150 E MARKET ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44481-1141
Practice Address - Country:US
Practice Address - Phone:330-394-6342
Practice Address - Fax:330-394-6029
Is Sole Proprietor?:No
Enumeration Date:2017-12-05
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator