Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) |
NPI | 1386051027 |
---|---|
Provider Name | Richard Reed |
First Address | Los Angeles, CA 90018 |
Second Address | Los Angeles, CA 90037-2923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2014 |
Last Update Date | 15/07/2014 |