Individual
MS. PETAGAYE LATOYA REYES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
9150 MARSHALL ST STE 14, PHILADELPHIA, PA 19114-2217
(215) 539-2470
(215) 539-2470
Mailing address
9150 MARSHALL ST STE 14, PHILADELPHIA, PA 19114-2217
(215) 539-2470
(215) 240-6328
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN553029
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP027047
PA
Other
Enumeration date
02/13/2023
Last updated
04/01/2026
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