Michael Justin Reynolds
Home Health Aide in Washington, DC. Individual provider (NPI-1).
NPI number1164035655
StatusActive
Last updated in NPPESAug 25, 2020
Details
- NPI
- 1164035655
- Entity type
- Individual (NPI-1)
- Name
- Michael Justin Reynolds
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 25, 2020
- Certification date
- Aug 25, 2020
- Last updated
- Aug 25, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374U00000X | Home Health Aide | – | – | Yes |
Practice location
3926 Southern Ave Se101
Washington, DC 20020-2002
Phone 202-378-7881
Mailing address
3926 Southern Ave Se Apt 101Washington, DC 20020-1123
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