Provider Demographics
NPI:1609400829
Name:REESE, KIEAVION M
Entity Type:Individual
Prefix:
First Name:KIEAVION
Middle Name:M
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 1:23221 ALDINE WESTFIELD RD # 200
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-7755
Mailing Address - Country:US
Mailing Address - Phone:346-888-0672
Mailing Address - Fax:
Practice Address - Street 1:23221 ALDINE WESTFIELD RD # 200
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-7755
Practice Address - Country:US
Practice Address - Phone:346-888-0672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-26
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst