Wallace Averal Reynolds Jr, PHD - Psychologist in Bartow, FL

Wallace Averal Reynolds Jr, PHD is a Psychologist based in Bartow, Florida. Wallace Averal Reynolds Jr is licensed to practice in Florida (license number PSY-6775) and his current practice location is 1625 S Hibiscus Dr, Bartow, Florida. He can be reached at his office (for appointments etc.) via phone at (863) 398-5996.

NPI number for Wallace Averal Reynolds Jr is 1942457189 and his current mailing address is 1625 S Hibiscus Dr, Bartow, Florida. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1942457189.

Contact Information

Wallace Averal Reynolds Jr, PHD
1625 S Hibiscus Dr,
Bartow, FL 33830-7242
(863) 398-5996
Not Available



Healthcare Provider's Profile

Full NameWallace Averal Reynolds Jr
GenderMale
SpecialityPsychologist
Location1625 S Hibiscus Dr, Bartow, Florida
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1942457189
  • Provider Enumeration Date: 08/19/2008
  • Last Update Date: 12/23/2014

Medical Identifiers

Medical identifiers for Wallace Averal Reynolds Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1942457189NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist PSY-6775 (Florida)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Wallace Averal Reynolds Jr is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Wallace Averal Reynolds Jr, PHD
1625 S Hibiscus Dr,
Bartow, FL 33830-7242

Ph: (863) 398-5996
Wallace Averal Reynolds Jr, PHD
1625 S Hibiscus Dr,
Bartow, FL 33830-7242

Ph: (863) 398-5996

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Psychologist in Bartow, FL

Dr. Tracy L Hartig, PSY.D.
Psychologist
Medicare: Not Enrolled in Medicare
Practice Location: 158 E Summerlin St, Bartow, FL 33830
Phone: 863-533-6471    

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