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General NPI Number Information
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NPI Number | 1053898296
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Entity Type | Individual
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Provider Name | HEIDI REID AMFT EXTERN
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Gender | Female
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Dates
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Enumeration Date | 07/20/2018
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Last Update Date | 07/20/2018
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Provider Practice Location Address
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Address Line | 199 N 290 W STE 150
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City | LINDON
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State | UT
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Zip | 84042-5004
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Country | US
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Telephone | 855-229-2336
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Fax |
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Provider Business Mailing Address
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Address Line | 1900 N 1400 E
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City | PROVO
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State | UT
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Zip | 84604-2153
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Country | US
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Telephone | 801-851-5406
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 108463383905
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License Number State | UT
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