Organization
MAUREEN LYONS REARDON, LLC
Active
Other names
M.L. Reardon, Ph.D., ABPP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAUREEN LYONS REARDON PH.D., ABPP (OWNER)
(910) 609-1990
Entity
Organization
Contact information
Practice address
2411 ROBESON ST, SUITE 200, FAYETTEVILLE, NC 28305-5576
(910) 609-1990
(910) 609-1993
Mailing address
5048 BARTONS ENCLAVE LN, RALEIGH, NC 27613-8564
(919) 800-1174
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TF0200X
Forensic Psychologist
3149
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19K0B
BLUE CROSS BLUE SHIELD NC
NC
Enumeration date
10/03/2016
Last updated
10/12/2016
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