Provider Demographics
NPI:1659627487
Name:REYNOLDS, ANNE (CCSLP)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:CCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10605 CONCORD ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-2504
Mailing Address - Country:US
Mailing Address - Phone:301-933-7880
Mailing Address - Fax:
Practice Address - Street 1:10605 CONCORD ST
Practice Address - Street 2:SUITE 102
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-2504
Practice Address - Country:US
Practice Address - Phone:301-933-7880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01497235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist