Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 0701002219 | VA |
N | 101YP2500X | Professional Counselor | 3528 | NC |
NPI | 1972556959 |
---|---|
Provider Name | Mrs. Esther C Reynolds |
First Address | Martinsville, VA 24112-2937 |
Second Address | Martinsville, VA 24112-2937 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 15/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
005404673 | (05) | VA |