Provider Demographics
NPI:1003104902
Name:REYNOSO, LUZ DEL ALBA (LCSW)
Entity Type:Individual
Prefix:
First Name:LUZ DEL ALBA
Middle Name:
Last Name:REYNOSO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 W. CHESTNUT HILL RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713
Mailing Address - Country:US
Mailing Address - Phone:302-358-6237
Mailing Address - Fax:888-358-6570
Practice Address - Street 1:179 W CHESTNUT HILL RD STE 6
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2210
Practice Address - Country:US
Practice Address - Phone:302-358-6237
Practice Address - Fax:888-358-6570
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00010091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical