Provider Demographics
NPI:1417142886
Name:REESE, LORI
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:REESE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 N GIBSON RD
Mailing Address - Street 2:APARTMENT 321
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89014-6710
Mailing Address - Country:US
Mailing Address - Phone:412-302-2683
Mailing Address - Fax:
Practice Address - Street 1:325 N GIBSON RD
Practice Address - Street 2:APARTMENT 321
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-6710
Practice Address - Country:US
Practice Address - Phone:412-302-2683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4740S104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker