Healthcare Provider Details

I. General information

NPI: 1780719237
Provider Name (Legal Business Name): RICHARD P REED PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 MENAUL BLVD NE SUITE A-330
ALBUQUERQUE NM
87112-1273
US

IV. Provider business mailing address

8500 MENAUL BLVD NE SUITE A-330
ALBUQUERQUE NM
87112-1273
US

V. Phone/Fax

Practice location:
  • Phone: 505-235-7096
  • Fax: 505-292-7769
Mailing address:
  • Phone: 505-235-7096
  • Fax: 505-292-7769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number147
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: