Individual
DR. NICHOLAS THOMAS DE LOS REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2051 EVERGREEN LN STE C, SHOW LOW, AZ 85901-7928
(562) 547-0910
Mailing address
PO BOX 268, SHOW LOW, AZ 85902-0268
(562) 547-0910
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
005077
AZ
103TC0700X
Clinical Psychologist
PSY9246
CA
106H00000X
Marriage & Family Therapist
MFT13850
CA
Other
Enumeration date
05/04/2007
Last updated
10/26/2021
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