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General NPI Number Information
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NPI Number | 1659641314
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Entity Type | Individual
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Provider Name | COLLEN R REEDY MA, LCMFT
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Gender | Male
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Dates
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Enumeration Date | 01/11/2012
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 2300 1ST ST NW LOWER LEVEL
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City | WASHINGTON
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State | DC
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Zip | 20001-1018
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Country | US
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Telephone | 443-602-1810
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 1ST ST NW LOWER LEVEL
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City | WASHINGTON
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State | DC
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Zip | 20001-1018
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Country | US
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Telephone | 443-602-1810
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LCM360
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License Number State | MD
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