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General NPI Number Information
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NPI Number | 1841208683
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Entity Type | Organization
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Legal Business Name | KERRI KENNEDY-REITER
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 01/13/2010
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Provider Practice Location Address
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Address Line | 110 E PECAN ST
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City | GAINESVILLE
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State | TX
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Zip | 76240-4812
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Country | US
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Telephone | 940-665-8056
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Fax | 940-665-8057
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Provider Business Mailing Address
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Address Line | 110 E PECAN ST
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City | GAINESVILLE
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State | TX
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Zip | 76240-4812
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Country | US
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Telephone | 940-665-8056
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Fax | 940-665-8057
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KERRI LEIGH KENNEDY-REITER
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Credential | LPC
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Telephone | 940-665-8056
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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 | 14194
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License Number State | TX
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