Doctor Name: | MS. TINA M. REED |
NPI Number: | 1174789580 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., L.P.C. |
License Number: | 002695 |
Business Practice Address: | #4 Southwest Street Van Buren, MO - 639650904 |
Business Phone Number: | 5733238796 |
Business Fax Number: | 5733230377 |
Mailing Address: | Po Box 904, VAN BUREN |
State: | MO |
Postal Code: | 639650904 |
Phone Number: | 5733238796 |
Fax Number: | 5733230377 |
NPI Enumeration Date: | 08/05/2008 |
NPI Last Update Date: | 08/05/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 002695 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |