Provider Demographics
NPI:1023221645
Name:REESE, RUTH E (MS, PHD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:E
Last Name:REESE
Suffix:
Gender:F
Credentials:MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 W AVENIDA DEL REY
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-2204
Mailing Address - Country:US
Mailing Address - Phone:623-486-0527
Mailing Address - Fax:
Practice Address - Street 1:4801 W AVENIDA DEL REY
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310-2204
Practice Address - Country:US
Practice Address - Phone:623-486-0527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-0772101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health