Provider Demographics
NPI:1205602224
Name:REEVES, CYNTHIA DENISE
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DENISE
Last Name:REEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12900 SHADOW CREEK PKWY APT 1312
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7473
Mailing Address - Country:US
Mailing Address - Phone:281-900-7154
Mailing Address - Fax:
Practice Address - Street 1:12900 SHADOW CREEK PKWY APT 1312
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7473
Practice Address - Country:US
Practice Address - Phone:281-900-7154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60620104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker