Provider Demographics
NPI:1679959522
Name:REID, RACHEL (MA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:REID
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 E SHERMAN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2761
Mailing Address - Country:US
Mailing Address - Phone:208-661-4667
Mailing Address - Fax:
Practice Address - Street 1:410 E SHERMAN AVE STE 201
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2761
Practice Address - Country:US
Practice Address - Phone:208-661-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60799069101YM0800X
WAMC60673276101YM0800X
IDLPC-7639101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health