Healthcare Provider Details

I. General information

NPI: 1992192116
Provider Name (Legal Business Name): PATRICIA LOUISA MAE REECE PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA LOUISA MAE REECE JONES PSYD

II. Dates (important events)

Enumeration Date: 04/26/2015
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

Practice location:
  • Phone: 945-253-5195
  • Fax:
Mailing address:
  • Phone: 945-253-5195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number30669
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number33810
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License Number33810
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number38110
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number30669
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number33810
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: