Provider Demographics
NPI:1881677466
Name:REESE, MARYANN (LMFT)
Entity Type:Individual
Prefix:
First Name:MARYANN
Middle Name:
Last Name:REESE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13663 KIMBERLY OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33774-2441
Mailing Address - Country:US
Mailing Address - Phone:727-596-4891
Mailing Address - Fax:727-595-0040
Practice Address - Street 1:414 JEFFORDS ST
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3828
Practice Address - Country:US
Practice Address - Phone:727-596-4891
Practice Address - Fax:727-595-0040
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT0000443106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist