Provider Demographics
NPI:1821082397
Name:REESE, DAWN R (PHD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:R
Last Name:REESE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1632 SE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-2386
Mailing Address - Country:US
Mailing Address - Phone:757-660-9656
Mailing Address - Fax:
Practice Address - Street 1:LRMC
Practice Address - Street 2:MUNSON CIRCLE 3765
Practice Address - City:LANDSTUHL
Practice Address - State:APO
Practice Address - Zip Code:09180
Practice Address - Country:DE
Practice Address - Phone:314-590-4619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10508103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA486705OtherMAMSI
VA230597OtherMHN
VA461293OtherANTHEM
VA007714068Medicaid
VA798985OtherVALUE OPTIONS
VA461293OtherANTHEM
VA798985OtherVALUE OPTIONS