Reynolds, Michael Connell

Reynolds, Michael Connell is an sole proprietor health care provider with primary practice located at 251 Country Club Dr , Eden NC 27288-3554. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Reynolds, Michael Connell can be contacted via phone (336) 635-1899.

Contact Information

Primary practice address
251 Country Club Dr Eden NC 27288-3554
Phone: (336) 635-1899
Fax: (336) 635-1899
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 4211 North Carolina
Behavioral Health & Social Service Providers / Professional 101YP2500X

Profile Details

NPI number 1265418560
LBN Legal business name Reynolds, Michael Connell
Credentials PH.D
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 19th, 2005
Last updated Mar 10th, 2014 - about 12 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 1265418560 NPPES
North Carolina MEDICAID 6102057

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