Reynolds, Brooke Elizabeth

Reynolds, Brooke Elizabeth is an individual health care provider with primary practice located at 5415C Backlick Rd , Springfield VA 22151-3915. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Reynolds, Brooke Elizabeth can be contacted via phone (703) 941-1910.

Contact Information

Primary practice address
5415C Backlick Rd Springfield VA 22151-3915
Phone: (703) 941-1910
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X 106S00000X Virginia

Profile Details

NPI number 1346816303
LBN Legal business name Reynolds, Brooke Elizabeth
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2021
Last updated Jun 1st, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346816303 NPPES
Virginia MEDICAID 1699097139

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