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NPI Code Detail

MEDICARE: TERRY REAMS PSY D

MEDICARE: TERRY REAMS PSY D
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
1103TC0700XClinical PsychologistKY-0890KY

General Provider Information

NPI Number : 1568509388
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRY REAMS PSY D
Provider Business Mailing Address
First Line : 202 CECILIA SMITH MILL RD
Second Line :
City : CECILIA
State : KY
Zip : 42724-9654
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 107 CRANES ROOST CT
Second Line :
City : ELIZABETHTOWN
State : KY
Zip : 42701-3650
Country : US
Telephone Number : 270-765-2605
Fax Number : 270-234-8572
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 07/08/2007

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