Provider Demographics
NPI:1679074405
Name:REYNOLDS, DANIKA RAE (PT, DPT)
Entity type:Individual
Prefix:
First Name:DANIKA
Middle Name:RAE
Last Name:REYNOLDS
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:DANIKA
Other - Middle Name:RAE
Other - Last Name:WATTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:
Practice Address - Street 1:540 LAFAYETTE RD # 100
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-3497
Practice Address - Country:US
Practice Address - Phone:973-726-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-27
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01779000225100000X
GACP034777T225100000X
MDCP034897T225100000X
MSCP034778T225100000X
TX1377196225100000X
PAPT030947225100000X
TN14778225100000X
SCCP034843T225100000X
NCP21583225100000X
NHCP034779T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist