Provider Demographics
NPI:1093471252
Name:REEVES, TASHUNDRA 310-856-0800 (NONE)
Entity Type:Individual
Prefix:
First Name:TASHUNDRA
Middle Name:310-856-0800
Last Name:REEVES
Suffix:
Gender:F
Credentials:NONE
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Mailing Address - Street 1:18726 S WESTERN AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90248-3858
Mailing Address - Country:US
Mailing Address - Phone:310-856-0800
Mailing Address - Fax:855-568-2494
Practice Address - Street 1:5400 W PLANO PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4855
Practice Address - Country:US
Practice Address - Phone:972-665-7251
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-12
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician