Provider Demographics
NPI:1548621394
Name:REYNOLDS, CHRISTOL ALFREDA
Entity type:Individual
Prefix:
First Name:CHRISTOL
Middle Name:ALFREDA
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 CHAPMAN BLVD APT C09
Mailing Address - Street 2:
Mailing Address - City:SOMERS POINT
Mailing Address - State:NJ
Mailing Address - Zip Code:08244-1656
Mailing Address - Country:US
Mailing Address - Phone:609-325-8207
Mailing Address - Fax:
Practice Address - Street 1:40 CHAPMAN BLVD APT C09
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244
Practice Address - Country:US
Practice Address - Phone:609-325-8207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator