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NPI Code Detail

MEDICARE: HALIE REEVES RBT

MEDICARE: HALIE REEVES RBT
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
1106S00000XBehavior TechnicianRBT-18-65226GA

General Provider Information

NPI Number : 1205319506
Entity Type Code : Individual
Provider Name (Legal Business Name) : HALIE REEVES RBT
Provider Business Mailing Address
First Line : 110 PIPEMAKERS CIR STE 116
Second Line :
City : POOLER
State : GA
Zip : 31322-4168
Country : US
Telephone Number : 912-330-7171
Fax Number :
Provider Business Practice Location Address
First Line : 110 PIPEMAKERS CIR STE 116
Second Line :
City : POOLER
State : GA
Zip : 31322-4168
Country : US
Telephone Number : 912-330-7171
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2018
Last Update Date : 09/12/2018

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Directions to “ HALIE REEVES RBT” Practice Location

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