MEDICARE: MARIANNE REID

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1538324827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANNE REID

Provider Business Mailing Address
First Line	:	PO BOX 52567
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92517-3567
Country	:	US
Telephone Number	:	951-358-4705
Fax Number	:	951-358-4719

Provider Business Practice Location Address
First Line	:	765 W BLAINE ST STE B
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92507-3940
Country	:	US
Telephone Number	:	951-358-4705
Fax Number	:	951-358-4719

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

Provider Enumeration Date	:	07/25/2008
Last Update Date	:	07/25/2008

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Directions to “ MARIANNE REID ” Practice Location

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