Individual
MS. KIM O MCREYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
1328 E OAK ST, WINSLOW, AZ 86047-4438
(928) 587-5575
(928) 289-0040
Mailing address
1328 E OAK ST, WINSLOW, AZ 86047-4438
(928) 587-5575
(928) 289-0040
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW11566
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
879885
—
AZ
Enumeration date
12/19/2006
Last updated
07/08/2007
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