MEDICARE: SUMMER CRISTIN REEVES

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	106S00000X	Behavior Technician		NM

General Provider Information

NPI Number	:	1225907264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUMMER CRISTIN REEVES

Provider Business Mailing Address
First Line	:	2600 PALMILLA RD NW STE A
Second Line	:
City	:	LOS LUNAS
State	:	NM
Zip	:	87031-4865
Country	:	US
Telephone Number	:	505-257-6574
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 PALMILLA RD NW STE A
Second Line	:
City	:	LOS LUNAS
State	:	NM
Zip	:	87031-4865
Country	:	US
Telephone Number	:	505-257-6574
Fax Number	:	505-257-6574

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

Provider Enumeration Date	:	10/29/2025
Last Update Date	:	10/29/2025

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Directions to “ SUMMER CRISTIN REEVES ” Practice Location

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