MEDICARE: DR. BARBARA KAY REESE PH.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
1	101YM0800X	Mental Health Counselor	15774	TX
2	101YM0800X	Mental Health Counselor	CCMH0196521	NM

General Provider Information

NPI Number	:	1790314227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBARA KAY REESE PH.D.

Provider Business Mailing Address
First Line	:	3553 ROMA DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-7577
Country	:	US
Telephone Number	:	575-339-9222
Fax Number	:

Provider Business Practice Location Address
First Line	:	ROMA DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-7577
Country	:	US
Telephone Number	:	575-339-9222
Fax Number	:

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

Provider Enumeration Date	:	04/06/2020
Last Update Date	:	05/17/2021

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