Provider Demographics
NPI:1023390960
Name:REICH, MICHELE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:REICH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 HENRY AVE APT D17
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2948
Mailing Address - Country:US
Mailing Address - Phone:570-436-5450
Mailing Address - Fax:
Practice Address - Street 1:8431 GERMANTOWN AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19118-3301
Practice Address - Country:US
Practice Address - Phone:570-436-5450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016848103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical