Provider Demographics
NPI:1376349183
Name:REECE-WILLIAMS, MICAELA (PSYD)
Entity type:Individual
Prefix:DR
First Name:MICAELA
Middle Name:
Last Name:REECE-WILLIAMS
Suffix:
Gender:X
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5045 W BASELINE RD, A105
Mailing Address - Street 2:210
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339
Mailing Address - Country:US
Mailing Address - Phone:609-961-1234
Mailing Address - Fax:
Practice Address - Street 1:10000 S WILMOT RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85756-8699
Practice Address - Country:US
Practice Address - Phone:520-574-0024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPSY-005861103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist