Individual
MISS DEASIA C REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4200 SOUTH FWY STE 630, FORT WORTH, TX 76115-1409
(817) 349-0680
Mailing address
4200 SOUTH FWY STE 630, FORT WORTH, TX 76115-1409
(817) 349-0680
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
113512
TX
104100000X
Social Worker
14722
TN
Other
Enumeration date
11/16/2021
Last updated
10/08/2024
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