Provider Demographics
NPI:1043939879
Name:REECE, RAYMOND LEE (MED)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:LEE
Last Name:REECE
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7855 DEER SPRINGS WAY APT 2136
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-4037
Mailing Address - Country:US
Mailing Address - Phone:702-528-0580
Mailing Address - Fax:
Practice Address - Street 1:7855 DEER SPRINGS WAY APT 2136
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-4037
Practice Address - Country:US
Practice Address - Phone:702-528-0580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst