MEDICARE: HALEY V REESE 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
1	104100000X	Social Worker	MSW011753	GA

General Provider Information

NPI Number	:	1073310363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HALEY V REESE MSW

Provider Business Mailing Address
First Line	:	1691 MERIWEATHER DR STE 109
Second Line	:
City	:	WATKINSVILLE
State	:	GA
Zip	:	30677-7787
Country	:	US
Telephone Number	:	706-883-5300
Fax Number	:

Provider Business Practice Location Address
First Line	:	1691 MERIWEATHER DR STE 109
Second Line	:
City	:	WATKINSVILLE
State	:	GA
Zip	:	30677-7787
Country	:	US
Telephone Number	:	706-883-5300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2025
Last Update Date	:	02/25/2025

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