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NPI Code Detail

MEDICARE: MS. PRISCILLA WILLIAMSON REYNOLDS MSW

MEDICARE:  MS. PRISCILLA WILLIAMSON REYNOLDS  MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW0314IAZ

General Provider Information

NPI Number : 1043290901
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PRISCILLA WILLIAMSON REYNOLDS MSW
Provider Business Mailing Address
First Line : 7360 N LA CHOLLA BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85741-2305
Country : US
Telephone Number : 520-877-8167
Fax Number : 520-531-1938
Provider Business Practice Location Address
First Line : 7360 N LA CHOLLA BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85741-2305
Country : US
Telephone Number : 520-877-8167
Fax Number : 520-531-1938
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 05/17/2013

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Directions to “ MS. PRISCILLA WILLIAMSON REYNOLDS MSW” Practice Location

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