Reynolds, Randal David

Reynolds, Randal David is an sole proprietor health care provider with primary practice located at 4401 Westown Pkwy Suite 309, West Des Moines IA 50266-6721. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Reynolds, Randal David can be contacted via phone (515) 440-3801.

Contact Information

Primary practice address
4401 Westown Pkwy Suite 309 West Des Moines IA 50266-6721
Phone: (515) 440-3801
Fax: (515) 440-3701
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 00993 Iowa

Profile Details

NPI number 1063431872
LBN Legal business name Reynolds, Randal David
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 19th, 2006
Last updated Jul 8th, 2007 - about 19 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 1063431872 NPPES
Iowa MEDICAID 0467068

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