Provider Demographics
NPI:1043681455
Name:REESE, DANA BETH (LCDC (LICENSED CHEMI)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:BETH
Last Name:REESE
Suffix:
Gender:F
Credentials:LCDC (LICENSED CHEMI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W. BOYD DRIVE,
Mailing Address - Street 2:SUITE D
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013
Mailing Address - Country:US
Mailing Address - Phone:972-359-1600
Mailing Address - Fax:972-200-7290
Practice Address - Street 1:200 W. BOYD DRIVE
Practice Address - Street 2:SUITE D
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013
Practice Address - Country:US
Practice Address - Phone:972-359-1600
Practice Address - Fax:972-200-7290
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLCDC#5148101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)