Provider Demographics
NPI:1548436157
Name:REYNOLDS, MARILYN YOUNG (RRT)
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:YOUNG
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3834 DRY FERN CV
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38135-2806
Mailing Address - Country:US
Mailing Address - Phone:901-650-6788
Mailing Address - Fax:
Practice Address - Street 1:3834 DRY FERN CV
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38135-2806
Practice Address - Country:US
Practice Address - Phone:901-650-6788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-03
Last Update Date:2008-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1843227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered