Provider Demographics
NPI:1790083871
Name:REYES, JENNY
Entity Type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 N WESTSHORE BLVD
Mailing Address - Street 2:SUITE # 300
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-4600
Mailing Address - Country:US
Mailing Address - Phone:813-281-5535
Mailing Address - Fax:813-281-5538
Practice Address - Street 1:1211 N WESTSHORE BLVD
Practice Address - Street 2:SUITE # 300
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-4600
Practice Address - Country:US
Practice Address - Phone:813-281-5535
Practice Address - Fax:813-281-5538
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker