Provider Demographics
NPI:1720841703
Name:REA, AISLING B (PHD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:AISLING
Middle Name:B
Last Name:REA
Suffix:
Gender:F
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11441 NW 39TH CT APT 317
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-7293
Mailing Address - Country:US
Mailing Address - Phone:954-464-5306
Mailing Address - Fax:
Practice Address - Street 1:11441 NW 39TH CT APT 317
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-7293
Practice Address - Country:US
Practice Address - Phone:954-464-5306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15836101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health