Provider Demographics
NPI:1699781526
Name:REYNOLDS, CYNTHIA LOUISE (PSYD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:LOUISE
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5341 W ATLANTIC AVE
Mailing Address - Street 2:304
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-8167
Mailing Address - Country:US
Mailing Address - Phone:561-498-7542
Mailing Address - Fax:561-499-4378
Practice Address - Street 1:5341 W ATLANTIC AVE
Practice Address - Street 2:304
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-8167
Practice Address - Country:US
Practice Address - Phone:561-498-7542
Practice Address - Fax:561-499-4378
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3790103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73243Medicare ID - Type Unspecified