Healthcare Provider Details

I. General information

NPI: 1750710455
Provider Name (Legal Business Name): MATTHEW REISER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 W UNIVERSITY BLVD
CEDAR CITY UT
84720-2415
US

IV. Provider business mailing address

4028 W 150 S
CEDAR CITY UT
84720-5503
US

V. Phone/Fax

Practice location:
  • Phone: 801-870-9052
  • Fax: 435-865-8078
Mailing address:
  • Phone: 801-870-9052
  • Fax: 435-865-8078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number5184406-2501
License Number StateUT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: