Provider Demographics
NPI:1164011771
Name:REZA, CASIE
Entity Type:Individual
Prefix:
First Name:CASIE
Middle Name:
Last Name:REZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CASIE
Other - Middle Name:
Other - Last Name:MABREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:320 WESTWAY PL STE 530
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1000
Mailing Address - Country:US
Mailing Address - Phone:817-516-9100
Mailing Address - Fax:
Practice Address - Street 1:320 WESTWAY PL STE 530
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1000
Practice Address - Country:US
Practice Address - Phone:817-516-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-18
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health