Doctor Name: | VIENNE REID |
NPI Number: | 1073916888 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 149016043 |
Business Practice Address: | 3330 W 177th St Suite 1f Hazel Crest, IL - 604292184 |
Business Phone Number: | 7084609833 |
Business Fax Number: | 7084601117 |
Mailing Address: | 500 Ravinia Pl, ORLAND PARK |
State: | IL |
Postal Code: | 604623758 |
Phone Number: | 7084609833 |
Fax Number: | 7084601117 |
NPI Enumeration Date: | 10/07/2014 |
NPI Last Update Date: | 10/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 149016043 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |