Provider Demographics
NPI:1568859213
Name:REIS, AMBER (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:
Last Name:REIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11010 PRAIRIE LAKES DR
Mailing Address - Street 2:#350
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-3884
Mailing Address - Country:US
Mailing Address - Phone:952-746-2522
Mailing Address - Fax:952-746-0887
Practice Address - Street 1:11010 PRAIRIE LAKES DR
Practice Address - Street 2:#350
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-3884
Practice Address - Country:US
Practice Address - Phone:952-746-2522
Practice Address - Fax:952-746-0887
Is Sole Proprietor?:No
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2678106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist