Provider Demographics
NPI:1790465953
Name:REYNOLDS, LINDSAY JULIANA (COUNSELOR)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:JULIANA
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:J
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COUNSELOR
Mailing Address - Street 1:320 LYNN AVE
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-3423
Mailing Address - Country:US
Mailing Address - Phone:321-480-7730
Mailing Address - Fax:
Practice Address - Street 1:320 LYNN AVE
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-3423
Practice Address - Country:US
Practice Address - Phone:321-480-7730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health