Provider Demographics
NPI:1629038484
Name:REES, TINA MARIE (MDIV, MA)
Entity Type:Individual
Prefix:MS
First Name:TINA
Middle Name:MARIE
Last Name:REES
Suffix:
Gender:F
Credentials:MDIV, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7650 S MCCLINTOCK DR STE 103-289
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-1672
Mailing Address - Country:US
Mailing Address - Phone:602-341-8241
Mailing Address - Fax:815-346-8241
Practice Address - Street 1:3200 N DOBSON RD BLDG C-108
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-9601
Practice Address - Country:US
Practice Address - Phone:602-341-8241
Practice Address - Fax:815-346-8241
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-12937101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional