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Individual

MR. JERRY W REECE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
2707 E 21ST ST N, WICHITA, KS 67214-2249
(316) 629-0249
Mailing address
11315 W CINDY ST, WICHITA, KS 67212-6542
(316) 722-0146

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
75
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100321990D
KS
Enumeration date
01/27/2012
Last updated
01/27/2012
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