Individual
REBECCA MARTINEZ REID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2201 E WOODSTOCK PL, BLOOMINGTON, IN 47401-6180
(812) 219-5867
(812) 219-5867
Mailing address
2201 E WOODSTOCK PL, BLOOMINGTON, IN 47401-6180
(812) 219-5867
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20043208A
IN
Other
Enumeration date
11/02/2018
Last updated
11/02/2018
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