Provider Demographics
NPI:1922742568
Name:REEVES, KAMBRIA (LAMFT)
Entity Type:Individual
Prefix:
First Name:KAMBRIA
Middle Name:
Last Name:REEVES
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4183 MIRINDA LN
Mailing Address - Street 2:
Mailing Address - City:AMMON
Mailing Address - State:ID
Mailing Address - Zip Code:83406-4644
Mailing Address - Country:US
Mailing Address - Phone:208-403-3067
Mailing Address - Fax:
Practice Address - Street 1:4183 MIRINDA LN
Practice Address - Street 2:
Practice Address - City:AMMON
Practice Address - State:ID
Practice Address - Zip Code:83406-4644
Practice Address - Country:US
Practice Address - Phone:208-403-3067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLAMFT-8791106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist