Healthcare Provider Details

I. General information

NPI: 1972572311
Provider Name (Legal Business Name): WENDY L REES MA NCC LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3645 N BRIARWOOD LN SUITE C
MUNCIE IN
47304
US

IV. Provider business mailing address

1410 N OLIVEWOOD CT
MUNCIE IN
47304-9408
US

V. Phone/Fax

Practice location:
  • Phone: 765-289-5520
  • Fax: 765-289-5840
Mailing address:
  • Phone: 765-288-5032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number39000860A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: