Provider Demographics
NPI:1720271885
Name:REILLY, JOCLYN DIEHL (MSW)
Entity Type:Individual
Prefix:
First Name:JOCLYN
Middle Name:DIEHL
Last Name:REILLY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JOCLYN
Other - Middle Name:WINDLE
Other - Last Name:DIEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:4045 LAKE OTIS PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5211
Mailing Address - Country:US
Mailing Address - Phone:907-337-5650
Mailing Address - Fax:
Practice Address - Street 1:1750 PATTERSON ST
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-2750
Practice Address - Country:US
Practice Address - Phone:907-337-5650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical