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NPI 1982437307

NPI 1982437307 : MELINA REYES LSW : MONTCLAIR, NJ

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General NPI Number Information
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    NPI Number           |    1982437307
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    Entity Type          |    Individual 
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    Provider Name        |    MELINA REYES LSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/21/2024
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    Last Update Date     |    02/12/2025
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Provider Practice Location Address
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    Address Line         |    51 UPPER MONTCLAIR PLZ 
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    City                 |    MONTCLAIR
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    State                |    NJ
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    Zip                  |    07043-1343
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    Country              |    US
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    Telephone            |    973-273-3717
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    54 AVENUE B APT 1 
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    City                 |    LODI
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    State                |    NJ
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    Zip                  |    07644-1814
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    Country              |    US
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    Telephone            |    
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    44SL06965800
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    License Number State |    NJ
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