Provider Demographics
NPI:1497075238
Name:REESE, KRISTEN LEE
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LEE
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 1:201 CHESTNUT AVE
Mailing Address - Street 2:PO BOX 352
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-4927
Mailing Address - Country:US
Mailing Address - Phone:814-946-5411
Mailing Address - Fax:814-941-1648
Practice Address - Street 1:400 LAKEMONT PARK BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602-5967
Practice Address - Country:US
Practice Address - Phone:814-946-5411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor