Provider Demographics
NPI:1821137456
Name:REESE, ANN MILLISON (PHD, PSYD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MILLISON
Last Name:REESE
Suffix:
Gender:F
Credentials:PHD, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 RARITAN AVENUE
Mailing Address - Street 2:SUITE # 307A
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2752
Mailing Address - Country:US
Mailing Address - Phone:732-846-2300
Mailing Address - Fax:
Practice Address - Street 1:320 RARITAN AVENUE
Practice Address - Street 2:SUITE # 307A
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2752
Practice Address - Country:US
Practice Address - Phone:732-846-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00389400103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist