Healthcare Provider Details

I. General information

NPI: 1821082397
Provider Name (Legal Business Name): DAWN R REESE PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

LRMC MUNSON CIRCLE 3765
LANDSTUHL APO
09180
DE

IV. Provider business mailing address

1632 SE 6TH AVE
CAPE CORAL FL
33990-2386
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-4619
  • Fax:
Mailing address:
  • Phone: 757-660-9656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY10508
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: