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General NPI Number Information
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NPI Number | 1003384025
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Entity Type | Organization
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Legal Business Name | SANDRA REESE INCORPORATED
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Dates
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Enumeration Date | 11/07/2018
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Last Update Date | 11/07/2018
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Provider Practice Location Address
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Address Line | 911 S BAKER ST
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-4711
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Country | US
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Telephone | 870-321-2544
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Fax |
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Provider Business Mailing Address
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Address Line | 911 S BAKER ST
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City | MOUNTAIN HOME
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State | AR
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Zip | 72653-4711
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Country | US
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Telephone | 870-321-2544
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SANDRA REESE
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Credential |
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Telephone | 870-321-2544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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