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General NPI Number Information
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NPI Number | 1134313166
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Entity Type | Individual
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Provider Name | ORLIE WHEATLY REID JR. LCSW-C
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Gender | Male
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Dates
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Enumeration Date | 09/03/2007
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Last Update Date | 09/03/2007
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Provider Practice Location Address
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Address Line | 2940 MERCHANT CT
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City | WALDORF
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State | MD
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Zip | 20603-5302
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Country | US
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Telephone | 240-462-3255
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Fax | 310-705-8944
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Provider Business Mailing Address
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Address Line | 2940 MERCHANT CT
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City | WALDORF
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State | MD
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Zip | 20603-5302
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Country | US
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Telephone | 240-462-3255
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Fax | 310-705-8944
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12188
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License Number State | MD
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