Individual
KATELYN SUZANNE REW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
3200 CLEMENTS RD, COTTONDALE, AL 35453-2137
(712) 355-8962
Mailing address
3200 CLEMENTS RD, COTTONDALE, AL 35453-2137
(712) 355-8962
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5927B
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7681040
DRIVER LICENSE
AL
Enumeration date
09/18/2019
Last updated
09/18/2019
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