| Mareda L. Reynolds Ma Pllc | |
|
200 Kanawha Ter Suite 103 Saint Albans WV 25177-2867 | |
| (304) 727-1302 | |
| (304) 727-1302 |
| Full Name | Mareda L. Reynolds Ma Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 200 Kanawha Ter, Saint Albans, West Virginia |
| Authorized Official Name and Position | Mareda Reynolds (OWNER) |
| Authorized Official Contact | 3047271302 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mareda L. Reynolds Ma Pllc Po Box 904 Saint Albans WV 25177-0904 Ph: (304) 727-1302 | Mareda L. Reynolds Ma Pllc 200 Kanawha Ter Suite 103 Saint Albans WV 25177-2867 Ph: (304) 727-1302 |
| NPI Number | 1114027653 |
|---|---|
| Provider Enumeration Date | 09/24/2006 |
| Last Update Date | 10/07/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114027653 | NPI | - | NPPES |
| 9204038000 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 790 (West Virginia) | Primary |
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