Provider Demographics
NPI:1679700686
Name:REEDY, AMARYAH SHALOM (MFTI)
Entity Type:Individual
Prefix:
First Name:AMARYAH
Middle Name:SHALOM
Last Name:REEDY
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 FLORAL AVE
Mailing Address - Street 2:SUITE 30
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-9143
Mailing Address - Country:US
Mailing Address - Phone:530-893-4784
Mailing Address - Fax:530-893-6144
Practice Address - Street 1:2550 FLORAL AVE
Practice Address - Street 2:SUITE 30
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-9143
Practice Address - Country:US
Practice Address - Phone:530-893-4784
Practice Address - Fax:530-893-6144
Is Sole Proprietor?:No
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54212106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist