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General NPI Number Information
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NPI Number | 1740679406
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Entity Type | Organization
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Legal Business Name | SARAH REYES, LCSW/PSYCHOTHERAPIST
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Dates
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Enumeration Date | 01/20/2015
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Last Update Date | 01/20/2015
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Provider Practice Location Address
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Address Line | 12151 KATHERWOOD ST
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City | SPRING HILL
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State | FL
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Zip | 34608-1523
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Country | US
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Telephone | 352-293-3263
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Fax |
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Provider Business Mailing Address
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Address Line | 12151 KATHERWOOD ST
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City | SPRING HILL
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State | FL
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Zip | 34608-1523
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Country | US
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Telephone | 352-293-3263
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MRS. SARAH EDITH REYES
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Credential | L.C.S.W
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Telephone | 352-293-3263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | SW 11947
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License Number State | FL
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