Provider Demographics
NPI:1376900993
Name:RENO, JOHN PAUL (MA, CCC-A)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:RENO
Suffix:
Gender:M
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3833 BAYBROOK LN
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-2259
Mailing Address - Country:US
Mailing Address - Phone:419-340-4733
Mailing Address - Fax:
Practice Address - Street 1:5800 PARK CENTER CT
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-0710
Practice Address - Country:US
Practice Address - Phone:419-724-8375
Practice Address - Fax:419-724-8375
Is Sole Proprietor?:No
Enumeration Date:2016-01-27
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01997231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist