Provider Demographics
NPI:1952634628
Name:REYNOLDS, DONNA H (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:H
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8304 GRAND MESSINA CIR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-7103
Mailing Address - Country:US
Mailing Address - Phone:561-315-2332
Mailing Address - Fax:
Practice Address - Street 1:1402 ROYAL PALM BEACH BLVD
Practice Address - Street 2:SUITE 400 B
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1691
Practice Address - Country:US
Practice Address - Phone:561-792-9272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 1911106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist