Provider Demographics
NPI:1265842207
Name:REESE, JULIANA (LPC)
Entity Type:Individual
Prefix:MS
First Name:JULIANA
Middle Name:
Last Name:REESE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:JULIANA
Other - Middle Name:
Other - Last Name:REESE-PETRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:22027 KENTON KNL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7848
Mailing Address - Country:US
Mailing Address - Phone:210-912-8291
Mailing Address - Fax:210-251-3214
Practice Address - Street 1:22027 KENTON KNL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7848
Practice Address - Country:US
Practice Address - Phone:210-912-8291
Practice Address - Fax:210-251-3214
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19490101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional