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General NPI Number Information
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NPI Number | 1821744996
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Entity Type | Organization
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Legal Business Name | REAWARE LICENSED CLINICAL SOCIAL WORK PROF CORP
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Dates
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Enumeration Date | 02/26/2022
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Last Update Date | 12/05/2022
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Provider Practice Location Address
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Address Line | 8885 RIO SAN DIEGO DR STE 237
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City | SAN DIEGO
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State | CA
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Zip | 92108-1661
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Country | US
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Telephone | 858-208-0432
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Fax |
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Provider Business Mailing Address
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Address Line | 8885 RIO SAN DIEGO DR STE 237
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City | SAN DIEGO
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State | CA
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Zip | 92108-1661
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Country | US
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Telephone | 858-208-0432
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANNE BARBER
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Credential |
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Telephone | 858-208-0432
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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 |
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License Number State |
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