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General NPI Number Information
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NPI Number | 1457808867
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Entity Type | Individual
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Provider Name | REESE MINSHEW PHD
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Gender | Female
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 1300 W BELMONT AVE 214
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City | CHICAGO
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State | IL
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Zip | 60657-3200
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Country | US
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Telephone | 773-683-1235
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Fax |
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Provider Business Mailing Address
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Address Line | 720 W GORDON TER 20B
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City | CHICAGO
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State | IL
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Zip | 60613-2269
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Country | US
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Telephone | 415-713-2661
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 021786
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License Number State | NY
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