Provider Demographics
NPI:1700239662
Name:REYNOLDS, SARAH (MSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:REYNOLDS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:2513 N PALO SANTO DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-1000
Mailing Address - Country:US
Mailing Address - Phone:520-328-9415
Mailing Address - Fax:
Practice Address - Street 1:2513 N PALO SANTO DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-1000
Practice Address - Country:US
Practice Address - Phone:520-328-9415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker