Healthcare Provider Details
I. General information
NPI: 1619841103
Provider Name (Legal Business Name): CLINIC BY REECE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/30/2025
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3313 VALLEY VIEW AVE NW
ROANOKE VA
24012-3919
US
IV. Provider business mailing address
3313 VALLEY VIEW AVE NW
ROANOKE VA
24012-3919
US
V. Phone/Fax
- Phone: 945-253-5195
- Fax:
- Phone: 945-253-5195
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
PATRICIA
REECE
Title or Position: CEO
Credential: PSYD
Phone: 945-253-5195