Provider Demographics
NPI:1992986632
Name:REASCO, AWILDA (MSW)
Entity type:Individual
Prefix:MRS
First Name:AWILDA
Middle Name:
Last Name:REASCO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 MIRIAM RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06053-1418
Mailing Address - Country:US
Mailing Address - Phone:860-223-2778
Mailing Address - Fax:
Practice Address - Street 1:51 MIRIAM ROAD
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-1418
Practice Address - Country:US
Practice Address - Phone:860-223-2778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical