Provider Demographics
NPI:1093068587
Name:REESE, JULIE ANN (DBH, LCSW)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:REESE
Suffix:
Gender:F
Credentials:DBH, LCSW
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DBH, LCSW
Mailing Address - Street 1:86 MDG, UNIT 3215
Mailing Address - Street 2:
Mailing Address - City:RAMSTEIN AB
Mailing Address - State:PROVINCE
Mailing Address - Zip Code:APO AE 09094
Mailing Address - Country:DE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:86 MDG, UNIT 3215
Practice Address - Street 2:
Practice Address - City:RAMSTEIN
Practice Address - State:PROVINCE
Practice Address - Zip Code:APO AE 09094
Practice Address - Country:DE
Practice Address - Phone:623-696-2949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-21
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ136661041C0700X
AZLCSW-154381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ13666OtherLICENSED MASTER OF SOCIAL WORK