Provider Demographics
NPI:1396284477
Name:REYNAUD, FLORENCE (LAC)
Entity type:Individual
Prefix:MRS
First Name:FLORENCE
Middle Name:
Last Name:REYNAUD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 LATOUR AVE
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-7206
Mailing Address - Country:US
Mailing Address - Phone:518-593-4254
Mailing Address - Fax:518-310-1170
Practice Address - Street 1:14 LATOUR AVE
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-7206
Practice Address - Country:US
Practice Address - Phone:518-593-4254
Practice Address - Fax:518-310-1170
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-22
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004520171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist