Provider Demographics
NPI:1710916895
Name:KATZ, REVA LEE (MSCI)
Entity Type:Individual
Prefix:MS
First Name:REVA
Middle Name:LEE
Last Name:KATZ
Suffix:
Gender:F
Credentials:MSCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10234 MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-6936
Mailing Address - Country:US
Mailing Address - Phone:907-770-1349
Mailing Address - Fax:
Practice Address - Street 1:10234 MEADOW RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99516-6936
Practice Address - Country:US
Practice Address - Phone:907-770-1349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered1744R1103XOther Service ProvidersSpecialistResearch Data Abstracter/Coder