Provider Demographics
NPI:1326850694
Name:REYNOLDS, ANNA MAGDALENE (ALC)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:MAGDALENE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 OLD ORRVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36701-6931
Mailing Address - Country:US
Mailing Address - Phone:334-877-3322
Mailing Address - Fax:
Practice Address - Street 1:1306 OLD ORRVILLE RD
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-6931
Practice Address - Country:US
Practice Address - Phone:334-877-3322
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALALC05128101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health