MEDICARE: CHRISTOPHER M REID TLMFT

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	101YM0800X	Mental Health Counselor	082696	IA

General Provider Information

NPI Number	:	1588107585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER M REID TLMFT

Provider Business Mailing Address
First Line	:	999 26TH ST
Second Line	:
City	:	MARION
State	:	IA
Zip	:	52302-3704
Country	:	US
Telephone Number	:	319-777-9347
Fax Number	:

Provider Business Practice Location Address
First Line	:	306 HIGHWAY 1 S STE B
Second Line	:
City	:	MOUNT VERNON
State	:	IA
Zip	:	52314-9501
Country	:	US
Telephone Number	:	319-214-9009
Fax Number	:

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

Provider Enumeration Date	:	11/22/2016
Last Update Date	:	11/22/2016

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