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General NPI Number Information
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NPI Number | 1538819867
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Entity Type | Organization
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Legal Business Name | REESE COUNSELING LLC
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 03/28/2022
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Provider Practice Location Address
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Address Line | 15437 ANACAPA RD
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City | VICTORVILLE
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State | CA
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Zip | 92392-2458
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Country | US
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Telephone | 760-220-7120
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Fax | 208-963-3040
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Provider Business Mailing Address
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Address Line | 1730 N SEVENOAKS WAY
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City | EAGLE
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State | ID
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Zip | 83616-6619
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Country | US
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Telephone | 760-220-7120
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | JACQUELINE REESE
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Credential | LMFT
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Telephone | 760-220-7120
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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 |
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License Number State |
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