Doctor Name: | ALLANA NICOLE REID |
NPI Number: | 1083957666 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 222 E Main St Ste 117 Barstow, CA - 923112361 |
Business Phone Number: | 7602551496 |
Business Fax Number: | |
Mailing Address: | 13680 Dellwood Rd, VICTORVILLE |
State: | CA |
Postal Code: | 923921282 |
Phone Number: | 9518701976 |
Fax Number: | |
NPI Enumeration Date: | 04/01/2013 |
NPI Last Update Date: | 04/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |