Doctor Name: | MS. JAN B REYNOLDS |
NPI Number: | 1174519318 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | LMHP - 1145/CMSW-683 |
Business Practice Address: | 2501 Capehart Rd Ehrling Bergquist Hospital - Family Advocacy Clinic Offutt A F B, NE - 681131043 |
Business Phone Number: | 4022947886 |
Business Fax Number: | 4022327291 |
Mailing Address: | 10867 Polk St, OMAHA |
State: | NE |
Postal Code: | 681374700 |
Phone Number: | 4022947886 |
Fax Number: | 4022327291 |
NPI Enumeration Date: | 09/23/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LMHP - 1145/CMSW-683 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |