MEDICARE: BRIANNA REYES RSST

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		MI

General Provider Information

NPI Number	:	1417720780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIANNA REYES RSST

Provider Business Mailing Address
First Line	:	2925 RUSSELL ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48207-4825
Country	:	US
Telephone Number	:	313-396-5300
Fax Number	:

Provider Business Practice Location Address
First Line	:	2925 RUSSELL ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48207-4825
Country	:	US
Telephone Number	:	313-396-5300
Fax Number	:

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

Provider Enumeration Date	:	10/30/2023
Last Update Date	:	03/12/2026

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Directions to “ BRIANNA REYES RSST” Practice Location

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