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General NPI Number Information
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NPI Number | 1528145364
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Entity Type | Individual
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Provider Name | TASCHA REESE LCSW-S
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/12/2016
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Provider Practice Location Address
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Address Line | 190 VZ COUNTY ROAD 2101
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City | CANTON
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State | TX
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Zip | 75103-3600
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Country | US
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Telephone | 903-372-6883
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Fax |
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Provider Business Mailing Address
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Address Line | 190 VZ COUNTY ROAD 2101
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City | CANTON
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State | TX
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Zip | 75103-3600
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Country | US
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Telephone | 903-372-6883
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 25108
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License Number State | TX
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