MEDICARE: JESSICA REIS

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	106H00000X	Marriage & Family Therapist	002584-01	NY

General Provider Information

NPI Number	:	1962359315
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA REIS

Provider Business Mailing Address
First Line	:	6247 NW 43RD TER
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33496-4045
Country	:	US
Telephone Number	:	516-592-9754
Fax Number	:

Provider Business Practice Location Address
First Line	:	6247 NW 43RD TER
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33496-4045
Country	:	US
Telephone Number	:	516-592-9754
Fax Number	:

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

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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