Individual
MRS. ANITA L REYNOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CAC II
Contact information
Practice address
1300 N 17TH AVE, GREELEY, CO 80631-9584
(970) 347-2120
Mailing address
1300 N 17TH AVE, GREELEY, CO 80631-9584
(970) 347-2120
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACB.0007876
CO
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
CSW.09926903
CO
172V00000X
Community Health Worker
—
—
Other
Enumeration date
09/23/2013
Last updated
09/22/2020
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