Doctor Name: | HOLLY ANNE REEVES |
NPI Number: | 1063761328 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 1645 |
Business Practice Address: | 626 S Montgomery St Apt 44 Starkville, MS - 397593827 |
Business Phone Number: | 6014668332 |
Business Fax Number: | |
Mailing Address: | 626 S Montgomery St Apt 44, STARKVILLE |
State: | MS |
Postal Code: | 397593827 |
Phone Number: | 6014668332 |
Fax Number: | |
NPI Enumeration Date: | 09/02/2012 |
NPI Last Update Date: | 09/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 1645 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |