Healthcare Provider Details

I. General information

NPI: 1720348709
Provider Name (Legal Business Name): GWENDOLYN LOUISA REES MSW; LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2012
Last Update Date: 05/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 E WILSON BRIDGE RD SUITE 250
WORTHINGTON OH
43085-2354
US

IV. Provider business mailing address

1271 HUNTER AVE APT D
COLUMBUS OH
43201-3292
US

V. Phone/Fax

Practice location:
  • Phone: 614-341-7090
  • Fax:
Mailing address:
  • Phone: 614-596-6179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberI.0010298
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: