Provider Demographics
NPI:1821821547
Name:REYNOLDS, ANDREA NICOLE (MHT)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:NICOLE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BATTLE MOUNTAIN
Mailing Address - State:NV
Mailing Address - Zip Code:89820-2834
Mailing Address - Country:US
Mailing Address - Phone:775-635-5753
Mailing Address - Fax:
Practice Address - Street 1:825 N 2ND ST
Practice Address - Street 2:
Practice Address - City:BATTLE MOUNTAIN
Practice Address - State:NV
Practice Address - Zip Code:89820-2834
Practice Address - Country:US
Practice Address - Phone:775-635-5753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician