Organization
COPIOUS LIFE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP ANTHONY REYNOLDS LCSW-C (CEO & PRESIDENT)
(202) 906-9588
Entity
Organization
Contact information
Practice address
6201 GREENBELT RD, BERWYN HEIGHTS, MD 20740-2354
(202) 906-9588
Mailing address
PO BOX 30381, BETHESDA, MD 20824-0381
(202) 906-9588
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14543
MD
Other
Enumeration date
12/11/2010
Last updated
12/11/2010
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