Individual
MICHAEL ADAM REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1227 E LOS ANGELES AVE, SIMI VALLEY, CA 93065-2871
(805) 582-4068
Mailing address
1227 E LOS ANGELES AVE, SIMI VALLEY, CA 93065-2871
(805) 582-4068
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1528420923
CA
171M00000X
Case Manager/Care Coordinator
R1528420923
CA
175T00000X
Peer Specialist
Primary
MPSS-FUBOHT
CA
390200000X
Student in an Organized Health Care Education/Training Program
R1528420923
CA
Other
Enumeration date
06/26/2023
Last updated
11/19/2024
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