Individual
BROOKE REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
333 CHURCH ST, WRANGELL, AK 99929-1231
(907) 874-2373
Mailing address
PO BOX 1231, WRANGELL, AK 99929-1231
(907) 874-2373
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001008
—
AK
Enumeration date
03/30/2010
Last updated
07/24/2020
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