Doctor Name: | IISHA REYES |
NPI Number: | 1174929202 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 671 Macduff Ln Unit B Winter Springs, FL - 327085396 |
Business Phone Number: | 3213682846 |
Business Fax Number: | |
Mailing Address: | 671 Macduff Ln, Unit B WINTER SPRINGS |
State: | FL |
Postal Code: | 327085396 |
Phone Number: | 3213682846 |
Fax Number: | |
NPI Enumeration Date: | 11/18/2014 |
NPI Last Update Date: | 11/18/2014 |
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: |