MEDICARE: REAGAN LEIGH ROCK

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

General Provider Information

NPI Number	:	1538947189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REAGAN LEIGH ROCK

Provider Business Mailing Address
First Line	:	64 S BEESON BLVD
Second Line	:
City	:	UNIONTOWN
State	:	PA
Zip	:	15401-3443
Country	:	US
Telephone Number	:	724-322-6142
Fax Number	:

Provider Business Practice Location Address
First Line	:	64 S BEESON BLVD
Second Line	:
City	:	UNIONTOWN
State	:	PA
Zip	:	15401-3443
Country	:	US
Telephone Number	:	724-322-6142
Fax Number	:

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

Provider Enumeration Date	:	09/15/2023
Last Update Date	:	09/15/2023

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Directions to “ REAGAN LEIGH ROCK ” Practice Location

Language	Start Address	Practice Location

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