Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 2347 | OH |
N | 103G00000X | Clinical Psychologist | 2347 | OH |
N | 103TC0700X | Clinical Psychologist | 2347 | OH |
N | 103TF0200X | Forensic Psychologist | 2347 | OH |
NPI | 1326189556 |
---|---|
Provider Name | Dr. Marvin Douglas Reed |
First Address | Mason, OH 45040-1895 |
Second Address | Mason, OH 45040-1895 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2007 |
Last Update Date | 09/07/2007 |