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General NPI Number Information
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NPI Number | 1740151687
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Entity Type | Individual
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Provider Name | KATIUSKA REYES
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Gender | Female
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 460 BLOOMFIELD AVE STE 209
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City | MONTCLAIR
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State | NJ
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Zip | 07042-3552
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Country | US
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Telephone | 732-674-9857
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Fax |
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Provider Business Mailing Address
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Address Line | 117 LIBERTY ST APT C
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-5049
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Country | US
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Telephone | 401-808-1531
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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 | 37FA00057700
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License Number State | NJ
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