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Organization

PSYCLINC

Active
Other names
Rebecca Reavis PhD
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARY REAVIS PH.D. (OWNER OF BUSINESS)
(704) 530-0850
Entity
Organization

Contact information

Practice address
518 S ASPEN ST, LINCOLNTON, NC 28092-2735
(704) 530-0850
(704) 735-9810
Mailing address
518 S ASPEN ST, LINCOLNTON, NC 28092-2735
(704) 530-0850
(704) 735-9810

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3163
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3163
LICENSE
NC
05
6000865
NC
05
6006696
NC
Enumeration date
05/07/2008
Last updated
01/22/2013
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