Provider Demographics
NPI:1205176880
Name:REEDER, VERONICA DARLENE (LPCC)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:DARLENE
Last Name:REEDER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3949 CORRALES RD STE 105
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-9347
Mailing Address - Country:US
Mailing Address - Phone:505-273-6300
Mailing Address - Fax:
Practice Address - Street 1:3949 CORRALES RD STE 105
Practice Address - Street 2:
Practice Address - City:CORRALES
Practice Address - State:NM
Practice Address - Zip Code:87048-9347
Practice Address - Country:US
Practice Address - Phone:505-273-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-19
Last Update Date:2019-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0199681101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional