Healthcare Provider Details

I. General information

NPI: 1851206353
Provider Name (Legal Business Name): DAVID R REESE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 MOUNTAIN MEADOW DR
JACKSON OH
45640-1198
US

IV. Provider business mailing address

570 MOUNTAIN MEADOW DR
JACKSON OH
45640-1198
US

V. Phone/Fax

Practice location:
  • Phone: 740-418-4323
  • Fax:
Mailing address:
  • Phone:
  • Fax: 740-418-4323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number00742
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: