Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | DC |
NPI | 1033655121 |
---|---|
Provider Name | Brandi Reynolds |
First Address | Washington, DC 20010-1538 |
Second Address | Washington, DC 20010-1538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2017 |
Last Update Date | 12/01/2017 |