Provider Demographics
NPI:1760808216
Name:RENO, ALISHIA JEAN
Entity Type:Individual
Prefix:MS
First Name:ALISHIA
Middle Name:JEAN
Last Name:RENO
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 1:414 N 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:PURCELL
Mailing Address - State:OK
Mailing Address - Zip Code:73080-3404
Mailing Address - Country:US
Mailing Address - Phone:405-314-9945
Mailing Address - Fax:
Practice Address - Street 1:2316 N INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2942
Practice Address - Country:US
Practice Address - Phone:405-801-2817
Practice Address - Fax:405-801-2071
Is Sole Proprietor?:No
Enumeration Date:2014-03-07
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health