MEDICARE: MISS AUNICE YVONNE REED AMFT, SUDCC

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	106H00000X	Marriage & Family Therapist	AMFT129879	CA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	8885	CA

General Provider Information

NPI Number	:	1912662446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS AUNICE YVONNE REED AMFT, SUDCC

Provider Business Mailing Address
First Line	:	2800 LAWRENCE CROSSLEY RD APT E4
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92264-6514
Country	:	US
Telephone Number	:	310-303-4290
Fax Number	:

Provider Business Practice Location Address
First Line	:	2800 LAWRENCE CROSSLEY RD APT E4
Second Line	:
City	:	PALM SPRINGS
State	:	CA
Zip	:	92264-6514
Country	:	US
Telephone Number	:	310-303-4290
Fax Number	:

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

Provider Enumeration Date	:	10/31/2021
Last Update Date	:	01/25/2022

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