MEDICARE: DR. CONSTANCE F. REES PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	22051	TX

General Provider Information

NPI Number	:	1033389515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CONSTANCE F. REES PH.D.

Provider Business Mailing Address
First Line	:	7128 WESTLAKE AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75214-3546
Country	:	US
Telephone Number	:	214-542-8195
Fax Number	:

Provider Business Practice Location Address
First Line	:	8100 LOMO ALTO DR
Second Line	:	SUITE 236
City	:	DALLAS
State	:	TX
Zip	:	75225-6530
Country	:	US
Telephone Number	:	214-502-7873
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2008
Last Update Date	:	03/11/2008

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