Provider Demographics
NPI:1710083704
Name:REED, NORMA WILSON (LCSW, LSOTP)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:WILSON
Last Name:REED
Suffix:
Gender:F
Credentials:LCSW, LSOTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5578
Mailing Address - Country:US
Mailing Address - Phone:915-542-1582
Mailing Address - Fax:
Practice Address - Street 1:1310 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5578
Practice Address - Country:US
Practice Address - Phone:915-542-1582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX024881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F0477Medicare PIN