Provider Demographics
NPI:1730348293
Name:REYNOLDS LANDS, FRANCES H (LMSW ICADC)
Entity type:Individual
Prefix:MRS
First Name:FRANCES
Middle Name:H
Last Name:REYNOLDS LANDS
Suffix:
Gender:F
Credentials:LMSW ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N 12TH AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-4746
Mailing Address - Country:US
Mailing Address - Phone:208-223-8842
Mailing Address - Fax:
Practice Address - Street 1:303 N 12TH AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-4746
Practice Address - Country:US
Practice Address - Phone:208-223-8842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW283851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical