Provider Demographics
NPI:1427517457
Name:REYNOLDS, MELISSA TAYLOR (BS)
Entity type:Individual
Prefix:MISS
First Name:MELISSA
Middle Name:TAYLOR
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 OLIVER ST
Mailing Address - Street 2:
Mailing Address - City:EASTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01027-9732
Mailing Address - Country:US
Mailing Address - Phone:413-887-9515
Mailing Address - Fax:
Practice Address - Street 1:8 ATWOOD DR
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-4266
Practice Address - Country:US
Practice Address - Phone:413-887-9515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health