Provider Demographics
NPI:1831330828
Name:REYNOLDS, RENEE SUZANNE
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:SUZANNE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 DIXIE DR
Mailing Address - Street 2:
Mailing Address - City:NEW LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45345-9746
Mailing Address - Country:US
Mailing Address - Phone:937-687-4287
Mailing Address - Fax:937-208-4515
Practice Address - Street 1:1065 DIXIE DR
Practice Address - Street 2:
Practice Address - City:NEW LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45345-9746
Practice Address - Country:US
Practice Address - Phone:937-687-4287
Practice Address - Fax:937-208-4515
Is Sole Proprietor?:No
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist