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General NPI Number Information
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NPI Number | 1831381763
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Entity Type | Individual
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Provider Name | GLENDA LEE REID LCSW
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Gender | Female
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Dates
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Enumeration Date | 08/14/2007
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Last Update Date | 08/29/2008
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Provider Practice Location Address
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Address Line | 150 E MEDA AVE SUITE 110
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City | GLENDORA
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State | CA
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Zip | 91741-2689
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Country | US
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Telephone | 626-705-2540
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Fax | 626-963-8320
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Provider Business Mailing Address
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Address Line | PO BOX 1453
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City | GLENDORA
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State | CA
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Zip | 91740-1453
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Country | US
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Telephone | 626-705-2540
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Fax | 626-963-8320
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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 | LCS15997
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License Number State | CA
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