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General NPI Number Information
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NPI Number | 1174789580
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Entity Type | Individual
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Provider Name | TINA M. REED M.A., L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 08/05/2008
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Last Update Date | 08/05/2008
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Provider Practice Location Address
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Address Line | #4 SOUTHWEST STREET
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City | VAN BUREN
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State | MO
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Zip | 63965-0904
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Country | US
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Telephone | 573-323-8796
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Fax | 573-323-0377
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Provider Business Mailing Address
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Address Line | PO BOX 904
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City | VAN BUREN
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State | MO
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Zip | 63965-0904
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Country | US
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Telephone | 573-323-8796
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Fax | 573-323-0377
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 002695
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License Number State | MO
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