Healthcare Provider Details

I. General information

NPI: 1871377507
Provider Name (Legal Business Name): REESE ALLEN HAMMOND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2023
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10273 YELLOW CIRCLE DRIVE
MINNETONKA MN
55343-9144
US

IV. Provider business mailing address

10273 YELLOW CIRCLE DRIVE
MINNETONKA MN
55343-9144
US

V. Phone/Fax

Practice location:
  • Phone: 952-401-9359
  • Fax: 952-854-5502
Mailing address:
  • Phone: 952-854-1800
  • Fax: 952-854-5502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: