MEDICARE: RAYMOND LEE REECE M.ED.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst

General Provider Information

NPI Number	:	1043939879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYMOND LEE REECE M.ED.

Provider Business Mailing Address
First Line	:	7855 DEER SPRINGS WAY APT 2136
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4037
Country	:	US
Telephone Number	:	702-528-0580
Fax Number	:

Provider Business Practice Location Address
First Line	:	7855 DEER SPRINGS WAY APT 2136
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89131-4037
Country	:	US
Telephone Number	:	702-528-0580
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2022
Last Update Date	:	08/24/2022

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