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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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