Provider Demographics
NPI:1962828624
Name:REECE, SHANA (PHD, HSP)
Entity Type:Individual
Prefix:DR
First Name:SHANA
Middle Name:
Last Name:REECE
Suffix:
Gender:F
Credentials:PHD, HSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7443 CHARLOTTE PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-5001
Mailing Address - Country:US
Mailing Address - Phone:615-417-6470
Mailing Address - Fax:
Practice Address - Street 1:1134 DOW ST
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37130-2486
Practice Address - Country:US
Practice Address - Phone:615-225-0562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-05
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3013103T00000X
TN7333355103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool