Provider Demographics
NPI:1396385530
Name:MICHAEL T. REID, PH.D. LLC
Entity Type:Organization
Organization Name:MICHAEL T. REID, PH.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:TALBOT
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-698-3006
Mailing Address - Street 1:1122 KENILWORTH DR STE 100
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2142
Mailing Address - Country:US
Mailing Address - Phone:410-881-3945
Mailing Address - Fax:410-881-3945
Practice Address - Street 1:1122 KENILWORTH DR STE 100
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2142
Practice Address - Country:US
Practice Address - Phone:410-881-3945
Practice Address - Fax:410-881-3945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty