Provider Demographics
NPI:1386214260
Name:REYNOLDS, KENSY (BCBA)
Entity Type:Individual
Prefix:
First Name:KENSY
Middle Name:
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 MEDICAL CENTER DR STE F
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1771
Mailing Address - Country:US
Mailing Address - Phone:469-678-8559
Mailing Address - Fax:
Practice Address - Street 1:12201 BEAR PLZ
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-0285
Practice Address - Country:US
Practice Address - Phone:817-562-0901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-01
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6160103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst