Individual
MARY BEATRICE REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1009 NW 5TH AVE, JEFFERSON REAVES HEALTH CENTER, MIAMI, FL 33136-3212
(786) 466-4000
(305) 585-4405
Mailing address
1009 NW 5TH AVE, JEFFERSON REAVES HEALTH CENTER, MIAMI, FL 33136-3212
(786) 466-4000
(305) 585-4405
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
PY7474
FL
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PY7474
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
472993025
TAX ID
FL
Enumeration date
09/17/2009
Last updated
02/09/2015
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