Doctor Name: | WILLIAM FREDERICK REYNOLDS |
NPI Number: | 1003975186 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | LSW0000000480 |
Business Practice Address: | 1312 Hanover St Ste B Chattanooga, TN - 374054353 |
Business Phone Number: | 4237562443 |
Business Fax Number: | |
Mailing Address: | 3529 Dell Trl, CHATTANOOGA |
State: | TN |
Postal Code: | 374114410 |
Phone Number: | 4236246821 |
Fax Number: | |
NPI Enumeration Date: | 12/06/2006 |
NPI Last Update Date: | 07/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LSW0000000480 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |