Provider Demographics
NPI:1447578109
Name:ANN PRICE REYNOLDS, PLLC
Entity Type:Organization
Organization Name:ANN PRICE REYNOLDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:PRICE
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMFT
Authorized Official - Phone:254-718-6527
Mailing Address - Street 1:3513 LAS MORAS DR
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-2134
Mailing Address - Country:US
Mailing Address - Phone:254-742-0299
Mailing Address - Fax:254-742-0434
Practice Address - Street 1:1005 MARLANDWOOD RD
Practice Address - Street 2:SUITE 107
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3329
Practice Address - Country:US
Practice Address - Phone:254-742-0299
Practice Address - Fax:254-742-0434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10588101YP2500X
TX3364106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1326046905Medicaid