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General NPI Number Information
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NPI Number | 1477887420
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Entity Type | Organization
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Legal Business Name | THERESA M REED PHD PC
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Dates
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Enumeration Date | 09/23/2009
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Last Update Date | 09/23/2009
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Provider Practice Location Address
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Address Line | 119 W FRONT ST SUITE 309
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City | MISSOULA
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State | MT
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Zip | 59802-4011
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Country | US
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Telephone | 406-327-6663
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Fax | 406-327-9987
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Provider Business Mailing Address
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Address Line | 119 W FRONT ST SUITE 309
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City | MISSOULA
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State | MT
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Zip | 59802-4011
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Country | US
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Telephone | 406-327-6663
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Fax | 406-327-9987
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | THERESA M REED
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Credential | PHD
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Telephone | 406-327-6663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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