| Doctor Name: | REISS POWELL |
| NPI Number: | 1104258458 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | P008243 |
| Business Practice Address: | 200 N Greensboro St Ste C6 Carrboro, NC - 275101849 |
| Business Phone Number: | 9199628387 |
| Business Fax Number: | 9199627373 |
| Mailing Address: | 200 N Greensboro St Ste C6, CARRBORO |
| State: | NC |
| Postal Code: | 275101849 |
| Phone Number: | 9199628387 |
| Fax Number: | 9199627373 |
| NPI Enumeration Date: | 08/08/2013 |
| NPI Last Update Date: | 05/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | P008243 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |