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Individual
PHYLLIS M REESMAN
Active
Individual
PHYLLIS M REESMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
000596
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538204904
BOONVILLE NPI
MO
01
—
1649269622
GROUP BILLING NPI
MO
01
—
203147
HEALTHLINK I.D. NUMBER
MO
01
—
22157
BCBS I.D. NUMBER
MO
01
—
3361
FEI I.D. NUMBER
MO
01
—
5763918
FIRST HEALTH I.D. NUMBER
MO
Enumeration date
07/26/2005
Last updated
07/13/2007
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