| Doctor Name: | MARY JO REID |
| NPI Number: | 1295993475 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 44SC00392600 |
| Business Practice Address: | 170 Changebridge Rd Suite B 3-2 Montville, NJ - 070459115 |
| Business Phone Number: | 9738955183 |
| Business Fax Number: | |
| Mailing Address: | 18 Willow Dr, RANDOLPH |
| State: | NJ |
| Postal Code: | 078694748 |
| Phone Number: | 9738955183 |
| Fax Number: | |
| NPI Enumeration Date: | 05/24/2008 |
| NPI Last Update Date: | 05/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 44SC00392600 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |