Provider Demographics
NPI:1710652250
Name:REYNOLDS, ABRAHAM GERALD (MA)
Entity Type:Individual
Prefix:MR
First Name:ABRAHAM
Middle Name:GERALD
Last Name:REYNOLDS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7270 CHELTENHAM WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-9657
Mailing Address - Country:US
Mailing Address - Phone:775-722-7985
Mailing Address - Fax:
Practice Address - Street 1:1665 OLD HOT SPRINGS RD
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-0782
Practice Address - Country:US
Practice Address - Phone:775-687-0870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPI030103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical