Individual
REATA GENE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
4412 74TH ST STE F100, LUBBOCK, TX 79424-2316
(210) 858-5898
(312) 260-7996
Mailing address
4412 74TH ST STE F100, LUBBOCK, TX 79424-2316
(210) 858-5898
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
107788
TX
104100000X
Social Worker
28875
MD
Other
Enumeration date
07/01/2024
Last updated
11/25/2024
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