Provider Demographics
NPI:1033619986
Name:REESER, MICHAEL GALE II (PHD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GALE
Last Name:REESER
Suffix:II
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 ERLANGER RD.
Mailing Address - Street 2:
Mailing Address - City:ERLANGER
Mailing Address - State:KY
Mailing Address - Zip Code:41018
Mailing Address - Country:US
Mailing Address - Phone:859-341-5782
Mailing Address - Fax:859-341-5783
Practice Address - Street 1:34 ERLANGER RD.
Practice Address - Street 2:
Practice Address - City:ERLANGER
Practice Address - State:KY
Practice Address - Zip Code:41018
Practice Address - Country:US
Practice Address - Phone:859-341-5782
Practice Address - Fax:859-341-5783
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY265760103T00000X, 103TA0400X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)