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General NPI Number Information
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NPI Number | 1164634721
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Entity Type | Individual
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Provider Name | BRENDA GAIL REEVES MSW
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1010 E 10TH ST
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City | TUCSON
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State | AZ
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Zip | 85719-5813
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Country | US
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Telephone | 520-232-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1106 S DUQUESNE DR
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City | TUCSON
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State | AZ
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Zip | 85710-4738
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Country | US
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Telephone | 520-790-4986
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Fax |
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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 | LCSW-11537
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License Number State | AZ
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